A randomized trial of unilateral and bilateral prefrontal cortex transcranial magnetic stimulation in treatment-resistant major depression

Abstract

There is no substantial difference in efficacy between unilateral right-sided rTMS and the two forms of bilateral rTMS assessed in the study. Furthermore, our results call into question the specificity between frequency and laterality and rTMS response.

Unilateral and bilateral MRI-targeted repetitive transcranial magnetic stimulation for treatment-resistant depression: a randomized controlled study

“…17,18 However, it has not been proven superior to unilateral rTMS. In 2 trials, Fitzgerald and colleagues 14,19 found no difference in response or remission rates between bilateral and unilateral rTMS. Neither study was sham-controlled.…”

“…13 Studies comparing HFL-rTMS and LFR-rTMS have found equivalent response rates with the 2 treatments. [14][15][16] Thus, combining these 2 treatments may result in…”

Bilateral prefrontal rTMS and theta burst TMS as an add-on treatment for depression: A randomized placebo controlled trial

“…the combination of high-frequency rTMS to the left DLPFC with low-frequency rTMS to the right DLPFC. The fi rst promising results of this technique (Fitzgerald et al 2006;Garcia-Toro et al 2006) could not be consistently replicated (McDonald et al 2006;Pallanti et al 2010;Fitzgerald et al 2011). However, a recent systematic review and meta-analysis (Berlim et al 2012) concluded that bilateral stimulation is more effective than sham stimulation and provides clinically relevant benefi ts comparable with standard antidepressant drug treatment and unilateral rTMS.…”

Equivalent beneficial effects of unilateral and bilateral prefrontal cortex transcranial magnetic stimulation in a large randomized trial in treatment-resistant major depression

“…Fitzgerald et al, 2006c;Fitzgerald et al, 2011), training in the TMS methods, trial management and ratings were conducted by the lead study site. This exclusion was based on seizure risk.…”