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An fMRI study of the effects of low- and high-frequency transcranial magnetic stimulation treatment in depression

Published online by Cambridge University Press:  24 June 2014

P Fitzgerald ,
A Srithiran ,
J Benitez ,
J Kulkarni  and
G Egan
P Fitzgerald
Affiliation:
Alfred Psychiatry Research Centre, The Alfred Monash University Department of Psychological Medicine
A Srithiran
Affiliation:
Alfred Psychiatry Research Centre, The Alfred Monash University Department of Psychological Medicine
J Benitez
Affiliation:
Alfred Psychiatry Research Centre, The Alfred Monash University Department of Psychological Medicine
J Kulkarni
Affiliation:
Alfred Psychiatry Research Centre, The Alfred Monash University Department of Psychological Medicine
G Egan
Affiliation:
Howard Florey Institute, The University of Melbourne, Melbourne, Australia
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Abstract

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Type
Abstracts from ‘Brainwaves’— The Australasian Society for Psychiatric Research Annual Meeting 2006, 6–8 December, Sydney, Australia
Information
Acta Neuropsychiatrica , Volume 18 , Issue 6 , December 2006 , pp. 287
Copyright
Copyright © 2006 Blackwell Munksgaard

Objective:

The study aimed to explore the effects of high-frequency, left-sided repetitive transcranial magnetic stimulation (rTMS) (HFL-TMS) and low-frequency stimulation to the right prefrontal cortex (LFR-TMS of HFL-TMS) using functional magnetic resonance imaging (fMRI) before and after a course of rTMS in patients with treatment-resistant depression (TRD).

Methods:

The study was a randomized parallel before and after trial using fMRI to study the effects of 3 weeks of daily HFL-TMS and LFR-TMS treatment. Twenty-six patients with TRD underwent rTMS treatment and were scanned with fMRI during a planning task pretreatment and after 3 weeks.

Results:

There was a significant reduction in depression severity for patients in both treatment groups [F(1, 24) = 17.5, P = 0.05). Responders to HFL-TMS showed an increase in task-related activation in prefrontal regions bilaterally. In contrast, responders to LFR-TMS showed a decrease in bilateral prefrontal activity. There were also differences in pretreatment scans between responders and nonresponders.

Conclusions:

Changes in task-related brain activation produced by HFL-TMS and LFR-TMS occur bilaterally in frontal brain regions but are opposite in direction, with high-frequency stimulation increasing and low-frequency stimulation decreasing task-related activation.