Original articleA Controlled Study of Repetitive Transcranial Magnetic Stimulation in Medication-Resistant Major Depression
Section snippets
Patients
The study procedures were approved by the Human Subjects Review Committee of the University of Washington. In addition, an Investigational Device Exemption was received from the U.S. Food and Drug Administration. All subjects gave written informed consent to participate in the study. The subjects were judged to have capacity to give informed consent by a board-certified psychiatrist. We carefully assessed the subjects for suicide risk and excluded subjects with active suicidal ideation or a
Treatment Efficacy
The TMS group had a significantly greater response rate, 30.6% (11/35), compared with 6.1% (2/33) in the sham group (Fisher’s p = .008, effect size = .69). The TMS group had a significantly greater remission rate, 20.0% (7/35), compared with 3.0% (1/33) in the sham group (Fisher’s p = .033, effect size = .58) (see Figure 2).
Logistic regression analyses, adjusting for the stratification variables, resulted in similar findings: the TMS group had significantly greater odds of response (adjusted
Discussion
In the largest sham-controlled study to date of high-frequency repetitive TMS as a treatment for medication-resistant depression, the response rates and remission rates were higher in the TMS group compared with the sham group. In addition, the HDRS and BDI score changes over time in the two groups indicated superiority of TMS over sham. There was no evidence of any cognitive compromise or adverse effects on neuropsychological functioning with TMS compared with sham, consistent with other
References (46)
- et al.
Repetitive transcranial magnetic stimulation is as effective as electroconvulsive therapy in the treatment of nondelusional major depressive disorderAn open study
Biol Psychiatry
(2000) - et al.
A randomized controlled comparison of electroconvulsive therapy and repetitive transcranial magnetic stimulation in severe and resistant nonpsychotic major depression
Biol Psychiatry
(2003) - et al.
Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depressionPreliminary results of a randomized trial
Biol Psychiatry
(2002) - et al.
Sham TMSIntracerebral measurement of the induced electrical field and the induction of motor-evoked potentials
Biol Psychiatry
(2001) - et al.
Transcranial magnetic stimulation (TMS) in controlled treatment studiesAre some “sham” forms active?
Biol Psychiatry
(2000) Repetitive transcranial magnetic stimulationWhat are the next steps?
Biol Psychiatry
(2000)- et al.
Therapeutic application of repetitive transcranial magnetic stimulationA review
Clin Neurophysiol
(2001) Transcranial magnetic stimulation in the treatment of depression
Essent Psychopharmacol
(2001)Meta-analysis of placebo-controlled trials with mirtazapine using the core items of the Hamilton Depression Scale as evidence of a pure antidepressive effect in the short-term treatment of major depression
Int J Neuropsychopharmacol
(2001)- et al.
Neuropsychiatric applications of transcranial magnetic stimulationA meta-analysis
Int J Neuropsychopharmacol
(2002)
Modulating neural networks with transcranial magnetic stimulation applied over the dorsal premotor and primary motor cortices
J Neurophysiol
A long-term, naturalistic study of usual standard-of-care treatment in patients with treatment resistant depression
Antidepressant efficacy and cognitive effects of repetitive transcranial magnetic stimulation in vascular depressionAn open trial
Int J Geriatr Psychiatry
Structured Clinical Interview for DSM-IV Disorders-Research Version (SCID-I, Version 2.0)
Transcranial magnetic stimulation in the treatment of depressionA double-blind, placebo-controlled trial
Arch Gen Psychiatry
Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Remission, recovery, relapse, and recurrence
Arch Gen Psychiatry
Transcranial Magnetic Stimulation in Neuropsychiatry
Transcranial magnetic stimulation in the treatment of depression
Am J Psychiatry
Some conceptual and statistical issues in analysis of longitudinal psychiatric data. Application to the NIMH treatment of Depression Collaborative Research Program dataset
Arch Gen Psychiatry
No deterioration of cognitive performance in an aggressive unilateral and bilateral antidepressant rTMS add-on trial
J Clin Psychiatry
A meta-analysis of repetitive transcranial magnetic stimulation in the treatment of depression
Psychopharmacol Bull
Erratum for “A meta-analysis of repetitive transcranial magnetic stimulation in the treatment of depression”
Psychopharmacol Bull
Antidepressant effects of repetitive transcranial magnetic stimulation
Br J Psychiatry
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