期刊
WORLD JOURNAL OF BIOLOGICAL PSYCHIATRY
卷 13, 期 6, 页码 423-435出版社
TAYLOR & FRANCIS LTD
DOI: 10.3109/15622975.2011.579163
关键词
Depression; transcranial magnetic stimulation; treatment resistance; elderly; clinical trial
类别
资金
- Ontario Mental Health Foundation (OMHF)
- Canadian Institutes of Health Research (CIHR) Clinician Scientist Award
- CIHR Fellowship
- National Health and Medical Research Council (NHMRC) Practitioner Fellowship
- Constance and Stephen Lieber through a National Alliance for Research on Schizophrenia and Depression (NARSAD) Lieber Young Investigator award
- Bristol-Meyers Squibb
- Eli Lilly
- Pfizer
- Wyeth
- Neuronetics Inc
- Aspect Medical Inc
Objectives. High frequency left-sided (HFL) and low frequency right-sided (LFR) unilateral repetitive transcranial magnetic stimulation (rTMS) are efficacious in treatment-resistant major depression (TRD). Similar benefit has been suggested for sequential bilateral rTMS (LFR then HFL). There are few published reports on the efficacy of sequential bilateral rTMS compared to HFL and sham rTMS. Therefore, this study evaluated the efficacy of HFL and sequential bilateral rTMS compared to sham in TRD. Methods. Subjects between the ages of 18 and 85 were recruited from a tertiary care university hospital. Seventy-four subjects with TRD and a 17-item Hamilton Depression Rating Scale (HDRS) greater than 21 were randomized to receive unilateral, bilateral, or sham rTMS. The rates of remission were compared among the three treatment groups. Results. The remission rates differed significantly among the three treatment groups using a modified intention to treat analysis that excluded subjects who did not respond to electroconvulsive therapy (ECT) during the current episode. The remission rate was significantly higher in the bilateral group than the sham group. The remission rate in the unilateral group did not differ from either group. Conclusion. These findings warrant larger controlled studies that compare the efficacy of sequential bilateral rTMS and HFL rTMS in TRD.
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