期刊
JOURNAL OF NEURAL TRANSMISSION
卷 126, 期 8, 页码 1105-1110出版社
SPRINGER WIEN
DOI: 10.1007/s00702-019-02037-5
关键词
Geriatric depression; Transcranial magnetic stimulation; Phenylalanine hydroxylase; Tryptophan metabolism; Neopterin
资金
- University of Innsbruck
- Medical University of Innsbruck
Repetitive transcranial magnetic stimulation (rTMS) has become a useful tool to treat different neuropsychiatric conditions such as depression, dementia and extrapyramidal syndromes insufficiently responding to conventional treatment. In this SHAM-controlled exploratory study safety, symptom improvement as well as changes in inflammation markers and neurotransmitter precursor amino acids availability were studied after a prefrontal cortex (PFC) stimulation using rTMS as add-on treatment in 29 patients with geriatric depression. Out of these, ten patients received SHAM treatment. Treatment was well tolerated, no serious adverse effects were observed. A clear improvement in symptoms of depression with a significant decrease in the HAMD-7 (U=3.306, p=0.001) was found by rTMS treatment. In parallel, serum phenylalanine dropped significantly (U=2.340, p<0.02), and there was a decline of tryptophan and of Phe/Tyr concentrations, both the effects, however, failed to reach the levels of statistical significance. In the patients who underwent SHAM treatment, no significant changes of HAMD-7 or the concentrations of any biomarker in the study could be found. In addition to the significant effect of rTMS on depression scores, these results point to a possible influence of rTMS on the enzyme phenylalanine hydroxylase (PAH), which plays a crucial role in the biosynthesis of neurotransmitter precursors related to geriatric depression.
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