Effects of repetitive transcranial magnetic stimulation on clinical, social, and cognitive performance in postpartum depression

Abstract

Background:This randomized, placebo-controlled, double-blind pilot study evaluated the impact of repetitive transcranial magnetic stimulation (rTMS) on clinical, cognitive, and social performance in women suffering with postpartum depression.Methods:Fourteen patients were randomized to receive 20 sessions of sham rTMS or active 5 Hz rTMS over the left dorsolateral prefrontal cortex. Psychiatric clinical scales and a neuropsychological battery were applied at baseline (pretreatment), week 4 (end of treatment), and week 6 (follow-up, posttreatment week 2).Results:The active rTMS group showed significant improvement 2 weeks after the end of rTMS treatment (week 6) in Hamilton Depression Rating Scale (P = 0.020), Global Assessment Scale (P = 0.037), Clinical Global Impression (P = 0.047), and Social Adjustment Scale-Self Report-Work at Home (P = 0.020).Conclusion:This study suggests that rTMS has the potential to improve the clinical condition in postpartum depression, while producing marginal gains in social and cognitive function.

Maternal Depression and Early Intervention

“…There is evidence for the efficacy of both newer antidepressants (selective serotonin reuptake inhibitors) and older tricyclic antidepressants in the treatment of postpartum depression (Wisner et al, 2006). Other evidence-based treatment modalities for postpartum depression include hormonal therapy (Moses-Kolko, Berga, Kalro, Sit & Wisner, 2009) such as the estrogen patch in the prevention and treatment of PPD, bright light therapy in antenatal depression (Wirz-Justice, 2011; Epperson et al, 2004; Oren et al, 2002) and the administration of repetitive transcranial magnetic stimulation (rTMS) during pregnancy (Kim et al, 2011; Zhang, Liu, Sun & Zheng, 2010) and postpartum (Garcia, Flynn, Pierce & Caudle, 2010; Myczkowski et al, 2012). .…”

Treatment Repetitive Transcranial Magnetic Stimulation to Peripartum Depression: Systematic Review

“…as number of pulses, and number of session were different in all studies, but researcher consider interval time and stimulus duration to minimize adverse event like a seizure. [60] showed 7% decrease of HDRS scores in the placebo group, but in the experimetal group, they showed a more than 30% deccrease rate (p = 0.020), similar to antidepressants. In NRS, the response rate of the 56 participants was 33% and the mission rate was 59%.…”

“…In addition, not only the randomization clinical trials but follow up or cohort study about the children born after treatment should also be conducted. Although many studies considered health of fetus [59,61,[63][64][65][66][67]70], only Myczkowski et al [60] considered breastfeeding, and only Eryilmaz et al [88] conducted follow up study of children. One of the main advantages of rTMS is that it has negative effect on the baby.…”

“…There were a total of 11 selected literature related to the e cacy and safety of rTMS for PPD, of which 2 RCT studies [59,60], 4 NRS [61][62][63][64], and 5 case studies [64][65][66][67][68]. The total number of participants are 100, 83 of whom received activee rTMS treatment.…”

“…Because protocols for rTMS treatment for peripartum depression have not yet been established, protocols for each study have all been different. 22 patients were stimulated the right DLPFC[59,61,66,67], 79 patients were stimulated the left DLPFC[60,[62][63][64][65][66]70], and Burton et al[69] attempted to treat using combination of…”