Acta neuropsychiatrica · 2020
Low-frequency rTMS inhibits the anti-depressive effect of ECT. A pilot study.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Buchholtz Poul Erik, Ashkanian Mahmoud, Hjerrild Simon, Hauptmann Line Kirstine, Devantier Torben Albert, Jensen Paulina, Wissing Sanne, Thorgaard Mette Viller, Bjerager Laerke, Lund Julie, Alrø Anja Johnsen, Speed Maria Simonsen, Brund Rene Børge Korsgaard, Videbech Poul
Аннотация
OBJECTIVE: Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex has been shown to have a statistically and clinically significant anti-depressant effect. The present pilot study was carried out to investigate if right prefrontal low-frequency rTMS as an add-on to electroconvulsive therapy (ECT) accelerates the anti-depressant effect and reduces cognitive side effects.
METHODS: In this randomised, controlled, double-blind study, thirty-five patients with major depression were allocated to ECT+placebo or ECT+low-frequency right prefrontal rTMS. The severity of depression was evaluated during the course using the Hamilton scale for depression (the 17-item as well as the 6-item scale) and the major depression inventory (MDI). Furthermore, neuropsychological assessment of cognitive function was carried out.
RESULTS: The study revealed no significant difference between the two groups for any of the outcomes, but with a visible trend to lower scores for MDI after treatment in the placebo group. The negative impact of ECT on neurocognitive functions was short-lived, and scores on logical memory were significantly improved compared to baseline 4 weeks after last treatment. The ECT-rTMS group revealed generally less impairment of cognitive functions than the ECT-placebo group.
CONCLUSION: The addition of low-frequency rTMS as an add-on to ECT treatment did not result in an accelerated response. On the contrary, the results suggest that low-frequency rTMS could inhibit the anti-depressant effect of ECT.
METHODS: In this randomised, controlled, double-blind study, thirty-five patients with major depression were allocated to ECT+placebo or ECT+low-frequency right prefrontal rTMS. The severity of depression was evaluated during the course using the Hamilton scale for depression (the 17-item as well as the 6-item scale) and the major depression inventory (MDI). Furthermore, neuropsychological assessment of cognitive function was carried out.
RESULTS: The study revealed no significant difference between the two groups for any of the outcomes, but with a visible trend to lower scores for MDI after treatment in the placebo group. The negative impact of ECT on neurocognitive functions was short-lived, and scores on logical memory were significantly improved compared to baseline 4 weeks after last treatment. The ECT-rTMS group revealed generally less impairment of cognitive functions than the ECT-placebo group.
CONCLUSION: The addition of low-frequency rTMS as an add-on to ECT treatment did not result in an accelerated response. On the contrary, the results suggest that low-frequency rTMS could inhibit the anti-depressant effect of ECT.
Предметные рубрики MeSH
AdultAgedAntidepressive AgentsCase-Control StudiesCognitionCombined Modality TherapyMajor Depressive DisorderDouble-Blind MethodElectroconvulsive TherapyFemaleHumansMaleMiddle AgedNeuropsychological TestsOutcome Assessment, Health CarePilot ProjectsPlacebo EffectPrefrontal CortexSeverity of Illness IndexTranscranial Direct Current StimulationTranscranial Magnetic Stimulation