Augmentative repetitive navigated transcranial magnetic stimulation (rTMS) in drug‐resistant bipolar depression

Dell’Osso, Bernardo; Mundo, Emanuela; D’Urso, Nazario; Pozzoli, Sara; Buoli, Massimiliano; Ciabatti, M.; Rosanova, Mario; Massimini, Marcello; Bellina, Valentina; Mariotti, Maurizio; Altamura, Alfredo Carlo

doi:10.1111/j.1399-5618.2008.00651.x

Cited by 121 publications

(86 citation statements)

References 40 publications

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“…Transcranial magnetic stimulation especially when combined with brain navigation could be efficient and well tolerated against refractory bipolar depression [142]. Sleep deprivation and other non-invasive circadian-related interventions could be useful add-on treatment in order to accelerate and sustain the antidepressant response [554].…”

Section: Other Agents and Therapeutic Modalitiesmentioning

confidence: 99%

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Fountoulakis

Kasper

Andreassen

et al. 2012

Eur Arch Psychiatry Clin Neurosci

118

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Section: Other Agents and Therapeutic Modalitiesmentioning

confidence: 99%

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Fountoulakis

Kasper

Andreassen

et al. 2012

Eur Arch Psychiatry Clin Neurosci

118

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“…Studies in our metaanalysis included patients with both unipolar and bipolar depression, and the underlying diagnosis was not a confounding variable. Importantly, the use of TMS for the treatment of depression in patients with bipolar disorder does not appear to induce mania [33,58,59] .…”

Section: Tms In Bipolar Depressionmentioning

confidence: 99%

Transcranial Magnetic Stimulation in the Management of Mood Disorders

Allan

Herrmann²,

Ebmeier³

2011

Neuropsychobiology

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Background: Many trials of transcranial magnetic stimulation (TMS) have used small samples and, therefore, lack power. Here we present an up-to-date meta-analysis of TMS in the treatment of depression. Methods: We searched Medline and Embase from 1996 until 2008 for randomized sham-controlled trials, with patients and investigators blinded to treatment, and outcome measured using a version of the Hamilton Depression Rating Scale (or similar). We identified 1,789 studies. Thirty-one were suitable for inclusion, with a cumulative sample of 815 active and 716 sham TMS courses. Results: We found a moderately sized effect in favour of TMS [Random Effects Model Hedges’ g = 0.64, 95% confidence interval (95% CI) = 0.50–0.79]. The corresponding Pooled Peto Odds Ratio for treatment response (≤50% reduction in depression scores) was 4.1 (95% CI = 2.9–5.9). There was significant variability between study effect sizes. Meta-regressions with relevant study variables did not reveal any predictors of treatment efficacy. Nine studies included follow-up data with an average follow-up time of 4.3 weeks; there was no mean change in depression severity between the end of treatment and follow-up (Hedges’ g = –0.02, 95% CI = –0.22 to +0.18) and no heterogeneity in outcome. Discussion: TMS appears to be an effective treatment; however, at 4 weeks’ follow-up after TMS, there had been no further change in depression severity. Problems with finding a suitably blind and ineffective placebo condition may have confounded the published effect sizes. If the TMS effect is specific, only further large double-blind randomized controlled designs with systematic exploration of treatment and patient parameters will help to define optimum treatment indications and regimen.

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“…Tamas and colleagues 87 compared four patients on active rTMS and one on placebo, obtaining a difference between groups only at week-6. Finally, in 2009, Dell'Osso and colleagues 88 performed an open-label study using low-frequency rTMS in 11 patients, showing significant reductions in all rating scales.…”

Section: Parameters Of Stimulationmentioning

confidence: 99%

Neuromodulation approaches for the treatment of major depression: challenges and recommendations from a working group meeting

Brunoni

Teng

Correa³

et al. 2010

Arq. Neuro-Psiquiatr.

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The use of neuromodulation as a treatment for major depressive disorder (MDD) has recently attracted renewed interest due to development of other non-pharmacological therapies besides electroconvulsive therapy (ECT) such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), and vagus nerve stimulation (VNS). Method: We convened a working group of researchers to discuss the updates and key challenges of neuromodulation use for the treatment of MDD. results: The state-of-art of neuromodulation techniques was reviewed and discussed in four sections: [1] epidemiology and pathophysiology of MDD; [2] a comprehensive overview of the neuromodulation techniques; [3] using neuromodulation techniques in MDD associated with non-psychiatric conditions; [4] the main challenges of neuromodulation research and alternatives to overcome them. Discussion: ECT is the first-line treatment for severe depression. TMS and tDCS are strategies with a relative benign profile of side effects; however, while TMS effects are comparable to antidepressant drugs for treating MDD; further research is needed to establish the role of tDCS. DBS and VNS are invasive strategies with a possible role in treatment-resistant depression. In summary, MDD is a chronic and incapacitating condition with a high prevalence; therefore clinicians should consider all the treatment options including invasive and non-invasive neuromodulation approaches. Key words: comprehensive review, major depressive disorder, ECT, TMS, clinical guidelines.Estratégias de neuromodulação para o tratamento da depressão maior: desafios e recomendações de uma força-tarefa rEsuMo O uso de técnicas de neuromodulação para o tratamento do transtorno depressivo maior (TDM) tem despertado um renovado interesse nos últimos anos com o desenvolvimento de outras intervenções não-farmacólogicas além da eletroconvulsoterapia (ECT), como a estimulação magnética transcraniana (EMT), a estimulação transcraniana por corrente continua (ETCC), a estimulação cerebral profunda (DBS) e a estimulação de nervo vago (VNS). Método: Nós organizamos um grupo de trabalho com vários pesquisadores para discutir os avanços recentes e os principais desafios para o uso da neuromodulação no tratamento os principais desafios da pesquisa na neuromodulação e alternativas para superá-los. Discussão: ECT é o tratamento de primeira linha para depressão grave. EMT e ETCC são estratégias com um perfil benigno de efeitos adversos; contudo, enquanto os efeitos da EMT são comparáveis ao das drogas antidepressivas para o tratamento da TDM, a eficácia da ETCC ainda precisa ser estabelecida por mais pesquisas clínicas. DBS e VNS são intervenções invasivas com um papel possível para a depressão refratária. Em resumo, TDM é uma condição crônica, incapacitante e de alta prevalência; portanto na prática clínica todas as opções de tratamento possíveis, incluindo as farmacológicas e não-farmacológicas, devem ser consideradas. Palavras-chave: artigo de revisão, tra...

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Augmentative repetitive navigated transcranial magnetic stimulation (rTMS) in drug‐resistant bipolar depression

Cited by 121 publications

References 40 publications

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Transcranial Magnetic Stimulation in the Management of Mood Disorders

Neuromodulation approaches for the treatment of major depression: challenges and recommendations from a working group meeting

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