Add-On rTMS for Medication-Resistant Depression: A Randomized, Double-Blind, Sham-Controlled Trial in Chinese Patients
J Clin Psychiatry 2005;66(7):930-937
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Repetitive transcranial magnetic
stimulation (rTMS) has been developed as a novel tool for
improving depression by delivering magnetic stimulation to the
brain. However, the apparent effects of rTMS on depression have
been varied in different studies. The aims of this study were to
determine whether left dorsolateral prefrontal cortex rTMS can
alleviate medication-resistant depression in Chinese patients and
to investigate what demographic variables or clinical features
may predict better response.
Method: We designed a 2-week randomized,
double-blind, sham-controlled study of add-on rTMS. A total of 30
medication-resistant patients with DSM-IV major depressive
disorder or bipolar disorder, depressed episode completed 10
sessions of active or sham rTMS--10 patients at each of 2
frequencies, faster (20 Hz) or slower (5 Hz) at 100% motor
threshold, and 10 patients at sham stimulation.
Results: Patients at both stimulation
frequencies demonstrated a superior reduction of depression
severity compared to sham stimulation (active = 55.7% vs.
sham = 16.3%). The response rate for active rTMS was 60%, in
contrast to 10% for the sham treatment. No difference in clinical
response was observed between 5 Hz and 20 Hz active rTMS.
Clinical variables showed that younger age and less severe
depression at entry may predict the clinical response to rTMS.
Except for 1 patient in which rTMS appeared to induce mania, this
procedure posed no safety problem.
Conclusions: To our knowledge, this is the first
study to demonstrate the clinical efficacy and safety of rTMS in
Chinese patients. Since not all the rTMS trials in previous
reports had positive results, further larger trials are still