Randomized controlled trial of transcranial magnetic stimulation in pregnant women with major depressive disorder

Kim, Deborah R.; Wang, Eileen; McGeehan, Brendan; Snell, Jessica; Ewing, Grace; Iannelli, Claudia; O’Reardon, John P.; Sammel, Mary D.; Epperson, C. Neill

doi:10.1016/j.brs.2018.09.005

Cited by 57 publications

(60 citation statements)

References 36 publications

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“…Five percent of the participans in the study experienced premature birth, but two have already shown signs of premature birth risk in a biomedical test and the average rate of women experiencing premature births worldwide is 9.1 to 13.4% [87], it is unlikely that the causal relationship that rTMS treatment causes premature births will be established and further research is required. It was con rmed that brachial exus injury was the only side effect that occurred in newborns, including premature births, and that it was not associated with rTMS treatment [59]. There were no actual side effects in the infant.…”

Section: Discussionmentioning

confidence: 95%

“…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.…”

Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

“…The people included in the study were suffering from severe depression with HDRS scores of 17 or more point, two of which showed biopolar disorder. 20 participants were treated antidepressants [61,63,66,69] along with rTMS, 6 participants were treated on psychotropic [59,64]and 1 participant was treated on clonazepam for insomnia [62]. 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.…”

Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

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Treatment Repetitive Transcranial Magnetic Stimulation to Peripartum Depression: Systematic Review

Lee¹,

Kim²,

Kwon³

2020

Preprint

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BackgroundPeripartum depression is a common disorder; it has very high potential hazards for both patients and their babies. Although peripartum depression therapy have typical options, antidepressant and electroconvulsive, these are not ensured concerning safe of fetus. Recently, repetitive Transcranial Magnetic Stimulation(rTMS) have been emerging as promising treatment for neuropathies including type of depression. Using magnetic field is expected to minimize effect on fetuses when used to treat peripartum depression. In this study, we are considering that whether the rTMS treatment is safe and effective for the mother and fetus in the treatment of peripartum depression.PurposePerforming systematical review, we confirm whether repetitive Transcranial Magnetic Stimulation is suitable treatment option for peripartum depression. MethodsA systematic review followed the PRISMA guidelines and meta-analysis was performed by CMA3 software. We investigated literature prior to July 2020 using databases including MEDLINE, PsycINFO, EMBASE and Cochrane libraries, and conducted bias evaluation for suitable literature. ResultsrTMS have an effect on mitigating depression with SMD = 1.394, 95% CI: 0.944 – 1.843 and. 37% of participants showed remission of the depression and 66% showed responded to repetitive Transcranial Magnetic Stimulation. A few side effect was reported and case of unusual side effect was two. However, we confirmed these are not related to TMS. There were no life-threatening side effects.ConclusionsrTMS might be an attractive alternative treatment for pregnant women who are afraid of chemical effect to their child and life threatening side effect of ECT. Furthermore, rTMS could reduce socioeconomic costs of peripartum depression However, much research is needed to determine standardized protocol and evaluate effectiveness.Systematic review registrationThis systematic review was not registered.

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Section: Discussionmentioning

confidence: 95%

Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

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Treatment Repetitive Transcranial Magnetic Stimulation to Peripartum Depression: Systematic Review

Lee¹,

Kim²,

Kwon³

2020

Preprint

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“…In a recently published randomized controlled trial ( N = 22) that was performed during the second or third trimester of pregnancy (randomized to either active or sham rTMS,1:1 ratio; 20 sessions; LFR; single train, 900 pulses per session, 100% MT), the authors reported rTMS to be safe and superior to sham stimulation on continuous outcomes. In a case series ( N = 29), authors reported a 41.4% and 20.7% response and remission rates, respectively, and the newborns had no abnormalities reported, all born at >36 weeks of gestational age, with mean Apgar scores of 8.1/8.8, with no abnormalities reported during a mean follow‐up of 3.7 years …”

Section: Special Populationsmentioning

confidence: 99%

An Update on Repetitive Transcranial Magnetic Stimulation for the Treatment of Major Depressive Disorder

Trevizol

Blumberger

2019

Clin Pharma and Therapeutics

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Repetitive transcranial magnetic stimulation (rTMS) has emerged as an evidenced‐based treatment for major depression that does not respond to standard first‐line therapies. The majority of data support the use of high‐frequency (10 Hz) treatment delivered to the left dorsolateral prefrontal cortex. Intermittent theta burst stimulation is a new emerging treatment that reduces the time required to deliver treatment and can increase capacity and access to this treatment. This review will comprehensively cover recent advancements in the field of rTMS for depression, including stimulation parameters and targets aimed at enhancing outcomes. In addition, efforts to use modern neuroscience tools to personalize this treatment and optimize outcomes will be reviewed.

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“…Moreover, in a RCT of twenty-two women with MDD in the second or third trimester of pregnancy that received 20 sessions of TMS to the right dorsolateral prefrontal cortex at 1 Hz as a single train of 900 pulses per session at 100% motor threshold, demonstrated that TMS was effective in reducing depressive symptoms in this sample of pregnant women. However, there is a possibility that TMS could be associated with late preterm birth, although a larger sample size would be needed to detect it [100]. Finally, the effect of rTMS therapy on mood has also been observed in patients with fibromyalgia [101].…”

Section: Medical Evidence and Clinical Effectiveness Of Classic Rtms-mentioning

confidence: 99%

Effects and Therapeutic Use of TMS in Psychiatric Disorders: An Evidence-Based Review

Bm¹,

Fern²,

Fj³

et al. 2019

Neuropsychiatry

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ObjectiveRecently we found that chronic immobilization stress (CIS) induced low levels of glutamate (Glu) and glutamine (Gln) and hypoactive glutamatergic signaling in the mouse prefrontal cortex (PFC), which was closely related with Glu-Gln cycle. Moreover, Gln-supplemented diet ameliorated CISinduced deleterious changes. In the present study, therefore, we investigated the effects of CIS and Gln supplementation on Glu-Gln cycle-related proteins to understand underlying mechanisms. MethodsUsing CIS-induced depression mouse model, we confirmed depressive behaviors caused by CIS and antidepressant property of Gln-supplementation with behavioral test and blood corticosterone assay. We examined expression of eleven proteins involving Glu-Gln cycle in the PFC. ResultsCIS decreased glutamate transporter 1 (GLT1), sodium-coupled neutral amino acid transporter (SNAT) 3, SNAT5, and mature SNAT2, suggesting excitotoxicity in synaptic cleft and shortage of Glu and Gln in astrocytes and neurons. Gln-supplementation did not affect non-stressed group, but significantly increased SNAT1 and SNAT3, which are the major Gln transporter in neurons and astrocytes respectively, as well as the mature SNAT2, implicating increasing transportation of Gln into neurons. ConclusionAs a result, we confirmed that CIS disturbed Glu-Gln cycle toward shortage of Glu and Gln levels in astrocytes and neurons, but Gln supplementation changed Glu-Gln cycle toward facilitating translocation of Gln into neurons for glutamatergic signaling. Moreover, these results also supported the antidepressant property of Gln.

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Randomized controlled trial of transcranial magnetic stimulation in pregnant women with major depressive disorder

Cited by 57 publications

References 36 publications

Treatment Repetitive Transcranial Magnetic Stimulation to Peripartum Depression: Systematic Review

Treatment Repetitive Transcranial Magnetic Stimulation to Peripartum Depression: Systematic Review

An Update on Repetitive Transcranial Magnetic Stimulation for the Treatment of Major Depressive Disorder

Effects and Therapeutic Use of TMS in Psychiatric Disorders: An Evidence-Based Review

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