Neurocognitive effects of repetitive transcranial magnetic stimulation in severe major depression.

Full Abstract

OBJECTIVE:
Repetitive transcranial magnetic stimulation (rTMS) is being investigated as a potential treatment for depression. Few studies have addressed the neurocognitive effects of a course of rTMS in severely depressed patients. We evaluated neurocognitive effects of a 1-4 week course (mean 3 weeks) of rTMS using an aggressive set of parameters, in 15 severely depressed subjects.

METHODS:
A battery of neurocognitive tests relevant to attention, working memory-executive function, objective memory and motor speed were administered to 15 subjects with treatment-resistant major depression (unipolar and bipolar), before and after a course of rTMS. Mean z scores were computed for each of 4 cognitive domains and analyzed using repeated measures multivariate analysis of covariance. Significant interactions were further clarified using univariate analysis of variance.

RESULTS:
There was no worsening of performance on any of the cognitive domains over the baseline-post rTMS period. On the contrary, evidence of modest but statistically significant improvement in performance was noted in working memory-executive function, objective memory and fine motor speed domains over the rTMS treatment period.

CONCLUSIONS:
There was no evidence of adverse neurocognitive changes over the baseline-post rTMS period in 15 treatment-resistant depressed subjects undergoing a 3 week (mean) trial of rTMS. Significant improvements in several domains observed over the rTMS treatment period could not be explained by improved mood. Practice effects as well as other factors potentially contributing to these findings are discussed.

SIGNIFICANCE:
rTMS is being increasingly studied as a neurophysiological probe as well as for its potential antidepressive effects. The effects on neuronal function raise appropriate questions of safety of its use at varying stimulus parameters and durations. This study contributes to the small body of evidence of the cognitive effects of rTMS in severely depressed patients.

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Author information

Author/s: Martis, Brian (B); Alam, Danesh (D); Dowd, Sheila M (SM); Hill, S Kristian (SK); Sharma, Rajiv P (RP); Rosen, Cherise (C); Pliskin, Neil (N); Martin, Eileen (E); Carson, Valorie (V); Janicak, Philip G (PG);

Affiliation: Department of Psychiatry, Psychiatric Clinical Research Center and Center for Cognitive Medicine, University of Illinois at Chicago, 912 South Wood Street Suite 137 MC 913, Chicago, IL 60612, USA. bmartis(-atsign-)psych.uic.edu

Grants: 1MO1RR13987-01 (Agency:NCRR NIH HHS)

Journal and publication information

Publication Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.

Journal: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology (Clin Neurophysiol), published in Netherlands. (Language: eng)

Reference: 2003-Jun; vol 114 (issue 6) : pp 1125-32

Dates: Created 2003/06/13; Completed 2003/08/01; Revised 2008/09/10;

PMID: 12804681, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Attention
Cognition Disorders - therapy
Depressive Disorder, Major - physiopathology; therapy
Electric Stimulation - methods
Electroconvulsive Therapy
Female
Humans
Male

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