Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-26T13:24:21.820Z Has data issue: false hasContentIssue false
  • English
  • Français

A 6-month follow-up study on response and relapse rates following an acute trial of repetitive transcranial magnetic stimulation in patients with major depression

Published online by Cambridge University Press:  04 September 2020

Chiara Arici ,
Beatrice Benatti Open the ORCID record for Beatrice Benatti [Opens in a new window] ,
Rita Cafaro Open the ORCID record for Rita Cafaro [Opens in a new window] ,
Laura Cremaschi ,
Luca Degoni ,
Sara Pozzoli ,
Lucio Oldani ,
Laura Molteni ,
Federica Giorgetti  and
Alberto Priori
...Show all authors
Chiara Arici
Affiliation:
Department of Mental Health and Addiction, ASST Vimercate, Vimercate, Italy
Beatrice Benatti
Affiliation:
Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Department of Mental Health, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy Department of Health Sciences, ‘Aldo Ravelli’ Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan Medical School, Milan, Italy
Rita Cafaro
Affiliation:
Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Department of Mental Health, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy
Laura Cremaschi
Affiliation:
Department of Mental Health and Addiction, ASST Papa Giovanni XXIII, Bergamo, Italy
Luca Degoni
Affiliation:
Department of Psychiatry, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
Sara Pozzoli
Affiliation:
Department of Psychiatry, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
Lucio Oldani
Affiliation:
Department of Psychiatry, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
Laura Molteni
Affiliation:
Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Department of Mental Health, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy
Federica Giorgetti
Affiliation:
Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Department of Mental Health, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy
Alberto Priori
Affiliation:
Department of Health Sciences, ‘Aldo Ravelli’ Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan Medical School, Milan, Italy Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
Caterina Viganò
Affiliation:
Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Department of Mental Health, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy
Bernardo Dell’Osso*
Affiliation:
Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Department of Mental Health, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy Department of Health Sciences, ‘Aldo Ravelli’ Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan Medical School, Milan, Italy Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
*
*Author for correspondence: Prof. Bernardo Dell’Osso, MD, Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Little is known about the post-acute effects of repetitive transcranial magnetic stimulation (rTMS) in patients with major depression. The present study focused on the 6-month follow-up of a sample of patients with major depression, after the completion of an acute 4 weeks rTMS trial, with the aim of evaluating response (in terms of sustained and late response) and relapse rates.

Methods

Following the completion of an acute trial of rTMS (T0-T4), 31 drug-resistant depressed patients (bipolar or unipolar) entered a naturalistic follow-up period of 6 months, with three timepoints (T5, T6, and T7) during which they were assessed with the Hamilton Depression Rating Scale and the Young Mania Rating Scale.

Results

Results showed that in the 6 months following an acute transcranial magnetic stimulation (TMS) trial, a higher rate of late responders was observed among previously acute TMS nonresponders (63.64%, 7 out of 11) compared to the rate of relapse among those who had acutely responded to TMS (10%, 2 out of 20). In addition, an overall high rate of maintained response (90%) was observed.

Conclusion

Present findings seem to support the possibility of obtaining a clinical response also after the end of an acute TMS trial in patients with major depression. The concomitant low rate of relapse observed at the end of follow-up along with a high rate of maintained response provides further support to the post-acute efficacy of TMS. Nonetheless, further controlled studies, with larger samples and longer follow-up observation, are needed to confirm the reported results.

Keywords

Major depressionfollow-uprepetitive TMS (rTMS)late responserelapse
Type
Original Research
Information
CNS Spectrums , Volume 27 , Issue 1 , February 2022 , pp. 93 - 98
Copyright
© The Author(s), 2020. Published by Cambridge University Press.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Davidson, RJ. Anterior electrophysiological asymmetries, emotion, and depression: conceptual and methodological conundrums. Psychophysiology. 1998;35(5):607–614. doi:10.1017/S0048577298000134CrossRefGoogle ScholarPubMed
Walpoth, M, Giupponi, G, Pycha, R, et al. Aspetti neurofisiologici e neuropsichiatrici della stimolazione magnetica transcranica. Quad Ital di Psichiatr. 2010;29(4):122–133. doi:10.1016/J.QUIP.2009.04.005CrossRefGoogle Scholar
Mayberg, HS. Limbic-cortical dysregulation: a proposed model of depression. J Neuropsychiatry Clin Neurosci. 1997;9(3):471–481. doi:10.1176/jnp.9.3.471Google ScholarPubMed
George, MS, Belmaker, RH. Transcranial Magnetic Stimulation in Clinical Psychiatry. American Psychiatric Publishing, Inc., 800 Maine Avenue, SW Suite 900 Washington, DC 20024; 2007.Google Scholar
Padberg, F, George, MS. Repetitive transcranial magnetic stimulation of the prefrontal cortex in depression. Exp Neurol. 2009;219(1):2–13. doi:10.1016/j.expneurol.2009.04.020CrossRefGoogle ScholarPubMed
Holtzheimer, PE, Russo, J, Avery, DH. A meta-analysis of repetitive transcranial magnetic stimulation in the treatment of depression. Psychopharmacol Bull. 2001;35(4):149–169.Google ScholarPubMed
Martin, JLR, Barbanoj, MJ, Schlaepfer, TE, Thompson, E, Pérez, V, Kulisevsky, J. Repetitive transcranial magnetic stimulation for the treatment of depression. Br J Psychiatry. 2003;182(6):480–491. doi:10.1192/bjp.182.6.480CrossRefGoogle ScholarPubMed
Couturier, JL. Efficacy of rapid-rate repetitive transcranial magnetic stimulation in the treatment of depression: a systematic review and meta-analysis. J Psychiatry Neurosci. 2005;30(2):83–90.Google ScholarPubMed
Dannon, PN, Dolberg, OT, Schreiber, S, Grunhaus, L. Three and six-month outcome following courses of either ECT or rTMS in a population of severely depressed individuals—preliminary report. Biol Psychiatry. 2002;51(8):687–690. doi:10.1016/S0006-3223(01)01274-4CrossRefGoogle ScholarPubMed
Fitzgerald, PB, Benitez, J, De Castella, AR, Brown, TL, Jeff Daskalakis, Z, Kulkarni, J. Naturalistic study of the use of transcranial magnetic stimulation in the treatment of depressive relapse. Aust New Zeal J Psychiatry. 2006;40(9):764–768. doi:10.1080/j.1440-1614.2006.01881.xCrossRefGoogle ScholarPubMed
Demirtas-Tatlidede, A, Mechanic-Hamilton, D, Press, DZ, et al. An open-label, prospective study of repetitive traescraeial magnetic stimulation (rTMS) in the long-term treatment of refractory depression: reproducibility and duration of the antidepressant effect in medication-free patients. J Clin Psychiatry. 2008;69(6):930–934. doi:10.4088/JCP.v69n0607CrossRefGoogle ScholarPubMed
Cohen, RB, Boggio, PS, Fregni, F. Risk factors for relapse after remission with repetitive transcranial magnetic stimulation for the treatment of depression. Depress Anxiety. 2009;26(7):682–688. doi:10.1002/da.20486CrossRefGoogle ScholarPubMed
Mantovani, A, Pavlicova, M, Avery, D, et al. Long-term efficacy of repeated daily prefrontal transcranial magnetic stimulation (TMS) in treatment-resistant depression. Depress Anxiety. 2012;29(10):883–890. doi:10.1002/da.21967CrossRefGoogle Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th Ed.). 5th ed. . Arlington, VA: American Psychiatric Association; 2013.Google Scholar
First MB. Structured clinical interview for the DSM (SCID). In: The Encyclopedia of Clinical Psychology. Hoboken, NJ: John Wiley & Sons, Inc.; 2015:1–6. doi:10.1002/9781118625392.wbecp351Google Scholar
Pacchiarotti, I, Mazzarini, L, Colom, F, et al. Treatment-resistant bipolar depression: towards a new definition. Acta Psychiatr Scand. 2009;120(6):429–440. doi:10.1111/j.1600-0447.2009.01471.xCrossRefGoogle ScholarPubMed
Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23(1):56–62. doi:10.1136/jnnp.23.1.56CrossRefGoogle ScholarPubMed
Nierenberg, AA, DeCecco, LM. Definitions of antidepressant treatment response, remission, nonresponse, partial response, and other relevant outcomes: a focus on treatment-resistant depression. J Clin Psychiatry. 2001;62(suppl 16):5–9.Google ScholarPubMed
Rossi, S, Hallett, M, Rossini, PM, Pascual-Leone A, Safety of TMS Consensus Group. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009;120(12):2008–2039. doi:10.1016/j.clinph.2009.08.016CrossRefGoogle ScholarPubMed
Dell’Osso, B, Oldani, L, Camuri, G, et al. Augmentative repetitive transcranial magnetic stimulation (rTMS) in the acute treatment of poor responder depressed patients: a comparison study between high and low frequency stimulation. Eur Psychiatry. 2015;30(2). doi:10.1016/J.EURPSY.2014.12.001CrossRefGoogle ScholarPubMed
Montgomery, SA, Asberg, M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979;134(4):382–389. doi:10.1192/bjp.134.4.382CrossRefGoogle ScholarPubMed
Hamilton, M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32(1):50–55. doi:10.1111/j.2044-8341.1959.tb00467.xCrossRefGoogle ScholarPubMed
Guy, W. ECDEU Assessment Manual for Psychopharmacology. Rockville, MD: US Department of Health, Education, and Welfare Public Health Service Alcohol, Drug Abuse, and Mental Health Administration; 1976.Google Scholar
Young, RC, Biggs, JT, Ziegler, VE, Meyer, DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133(11):429–435. doi:10.1192/bjp.133.5.429CrossRefGoogle ScholarPubMed
Dell’Osso, B, Camuri, G, Castellano, F, et al. Meta-review of metanalytic studies with repetitive transcranial magnetic stimulation (rTMS) for the treatment of major depression. Clin Pract Epidemiol Ment Heal. 2011;7(1):167–177. doi:10.2174/1745017901107010167CrossRefGoogle ScholarPubMed
Prudic, J, Haskett, RF, McCall, WV, et al. Pharmacological strategies in the prevention of relapse after electroconvulsive therapy. J ECT. 2013;29(1):3–12. doi:10.1097/YCT.0b013e31826ea8c4CrossRefGoogle ScholarPubMed
Martinotti, G, Montemitro, C, Pettorruso, M, et al. Augmenting pharmacotherapy with neuromodulation techniques for the treatment of bipolar disorder: a focus on the effects of mood stabilizers on cortical excitability. Expert Opin Pharmacother. 2019;20(13):1575–1588. doi:10.1080/14656566.2019.1622092CrossRefGoogle ScholarPubMed
Bocchio-Chiavetto, L, Miniussi, C, Zanardini, R, et al. 5-HTTLPR and BDNF Val66Met polymorphisms and response to rTMS treatment in drug resistant depression. Neurosci Lett. 2008;437(2): 130–134. doi:10.1016/J.NEULET.2008.04.005CrossRefGoogle ScholarPubMed
Zanardini, R, Gazzoli, A, Ventriglia, M, et al. Effect of repetitive transcranial magnetic stimulation on serum brain derived neurotrophic factor in drug resistant depressed patients. J Affect Disord. 2006;91(1):83–86. doi:10.1016/j.jad.2005.12.029CrossRefGoogle ScholarPubMed
Fregni, F, Pascual-Leone, A. Technology insight: noninvasive brain stimulation in neurology—perspectives on the therapeutic potential of rTMS and tDCS. Nat Clin Pract Neurol. 2007;3(7):383–393. doi:10.1038/ncpneuro0530CrossRefGoogle ScholarPubMed
Yukimasa, T, Tamagawa, A, Uozumi, T, et al. High-frequency repetitive transcranial magnetic stimulation improves refractory depression by influencing catecholamine and brain-derived neurotrophic factors. Pharmacopsychiatry. 2006;39(2):52–59. doi:10.1055/s-2006-931542CrossRefGoogle ScholarPubMed
Mitchell, PB, Loo, CK. Transcranial magnetic stimulation for depression. Aust N Z J Psychiatry 2006;40(5):406–413. doi:10.1080/j.1440-1614.2006.01816.xCrossRefGoogle ScholarPubMed
Rappoport, N, Shamir, R. Inaccuracy of the log-rank approximation in cancer data analysis. Mol Syst Biol. 2019;15(8). doi:10.15252/msb.20188754CrossRefGoogle ScholarPubMed