Repetitive Transcranial Magnetic Stimulation (rTMS) in the treatment of Panic Disorder (PD) with comorbid major depression

Mantovani, Antonio; Lisanby, Sarah H.; Pieraccini, Fulvio; Ulivelli, Monica; Castrogiovanni, Paolo; Rossi, Símone

doi:10.1016/j.jad.2006.11.027

Cited by 65 publications

(30 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These results confirm the study by Mantovani et al [34] that shows that the application of slow rTMS to the right DLPFC for the treatment of panic disorder with comorbid major depression increases the resting motor threshold in right hemisphere and so reduces the ipsilateral motor cortex excitability. This study, however, did not value the resting motor threshold in left hemisphere, the motor cortex excitability in left hemisphere and so did not value the relationship between right hemisphere and left hemisphere.…”

Section: Discussionsupporting

confidence: 92%

“…Triggs et al [20] reported that a 10-day course of left prefrontal high-frequency rTMS was associated with a decrease in the resting motor threshold in the left hemisphere. Mantovani et al [34] reported that a 10-day course of right prefrontal low-frequency rTMS was associated with increase in the resting motor threshold in right hemisphere. Chistyakov et al [35] reported that a 10-day course of left prefrontal high-frequency rTMS was associated with decrease in cortical excitability in the left hemisphere, but did not show any change in resting motor threshold.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Low-Frequency rTMS over Right Dorsolateral Prefrontal Cortex in the Treatment of Resistant Depression: Cognitive Improvement Is Independent from Clinical Response, Resting Motor Threshold Is Related to Clinical Response

et al. 2012

View full text Add to dashboard Cite

Background: Clinical studies have shown that repetitive transcranial magnetic stimulation (rTMS) is effective in a certain percentage of treatment-resistant depression (TRD). The left dorsolateral prefrontal cortex (DLPFC) 10 Hz rTMS stimulation received FDA approval in 2008, although different rTMS protocols have also shown their effectiveness in reducing depressive symptoms. We investigated the clinical, cognitive and neurophysiologic effects of a 3 weeks’ protocol of low-frequency rTMS applied over the right DLPFC in resistant depression. Methods: Twenty-eight patients with TRD (age range 28–55) received low-frequency rTMS (1 Hz) over the right DLPFC in a 3-week open trial. Hamilton scales for depression and anxiety, Corsi block-tapping test, phonemic verbal fluency, right and left resting motor thresholds were evaluated in each subject over the trial period. Results: At the end of the trial 42.9% of the subjects were considered as responders. A significant reduction of both HAMD (p < 0.001) and HAMA (p < 0.01) total scores was observed. At the 3rd week, the performances in Corsi test (p < 0.02) and phonemic verbal fluency (p = 0.065) were improved independently from depressive symptoms variation. At the end of the rTMS protocol, a significantly decreased left hemisphere resting motor threshold was registered (p < 0.01), while right hemisphere resting motor threshold did not show significant variation. Conclusion: Low-frequency rTMS over the right DLPFC appeared effective in 42.9% of depressive resistant subjects in this sample. A significant decrease in left hemisphere resting motor threshold was observed only in responders, while a trend for improvement in cognitive function has been found and appeared independent from clinical response.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Low-Frequency rTMS over Right Dorsolateral Prefrontal Cortex in the Treatment of Resistant Depression: Cognitive Improvement Is Independent from Clinical Response, Resting Motor Threshold Is Related to Clinical Response

et al. 2012

View full text Add to dashboard Cite

show abstract

“…To test the clinical effects of low-frequency rTMS (1 Hz) on the right dorsolateral prefrontal cortex of patients with PD and depression who are resistant or intolerant to medication, Zwanzger et al 55 observed that after two weeks of rTMS treatment there was significant improvement in symptoms of anxiety and depression, corroborating the findings of Mantovani et al 56 Later, Mantovani et al 32 demonstrated that, after four weeks of low-frequency rTMS stimulation of the right dorsolateral prefrontal cortex, patients who received real treatment fared better than those who received only sham stimulation. It can therefore be concluded that low-frequency rTMS on the right dorsolateral prefrontal cortex improves symptoms of major depression and anxiety disorders 55 .…”

Section: Right-sided Low-frequency Rtms and Pdmentioning

confidence: 67%

Transcranial magnetic stimulation and transcranial direct current stimulation appear to be safe neuromodulatory techniques useful in the treatment of anxiety disorders and other neuropsychiatric disorders

Iannone

Cruz

Brasil‐Neto

et al. 2016

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Transcranial magnetic stimulation (TMS) has recently been investigated as a possible adjuvant treatment for many neuropsychiatric disorders, and has already been approved for the treatment of drug-resistant depression in the United States and in Brazil, among other countries. Although its use in other neuropsychiatric disorders is still largely experimental, many physicians have been using it as an off-label add-on therapy for various disorders. More recently, another technique, transcranial direct current stimulation (tDCS), has also become available as a much cheaper and portable alternative to TMS, although its mechanisms of action are different from those of TMS. The use of off-label therapeutic TMS or tDCS tends to occur in the setting of diseases that are notoriously resistant to other treatment modalities. Here we discuss the case of anxiety disorders, namely panic and post-traumatic stress disorders, highlighting the uncertainties and potential problems and benefits of the clinical use of these neuromodulatory techniques at the current stage of knowledge.

show abstract

“…A recent study has shown the efficacy of LFR rTMS on the DLPFC in patients with comorbid panic and depression, with a sustained improvement of panic symptoms in more than 80% of patients [52] . Moreover, Fitzgerald et al [19] have found that a higher score on the CORE psychomotor agitation scale was associated with a major clinical improvement with response to LFR rTMS, but not with HFL rTMS.…”

Section: Discussionmentioning

confidence: 99%

A Symptom-Specific Analysis of the Effect of High-Frequency Left or Low-Frequency Right Transcranial Magnetic Stimulation over the Dorsolateral Prefrontal Cortex in Major Depression

et al. 2010

View full text Add to dashboard Cite

Background: We have investigated the efficacy of high-frequency left (HFL) versus low-frequency right (LFR) repetitive transcranial magnetic stimulation (rTMS) in depression, focusing on specific symptoms as possible predictors of outcome for these two different types of stimulation. Method: Seventy-four outpatients with a major depressive episode treated with an adequate antidepressant dosage for at least 4 weeks were included in our study and randomly assigned to two different groups: HFL or LFR rTMS. The Hamilton Rating Scale for Depression (HAM-D) items were pooled into 6 factors to evaluate specific symptoms as possible predictors of response. Results: Twenty-one out of 32 patients (65.6%) and 24 out of 42 patients (57.1%) were responders in the HFL and LFR groups, respectively. No significant difference in response rate was observed. Considering the whole sample, we found an inverse correlation between activity and HAM-D score reduction and a significant positive relation between somatic anxiety and outcome. An inverse correlation between psychic anxiety and HAM-D score reduction emerged considering the HFL group. In the LFR group, there was a significant negative relationship between baseline activity and the outcome. Conclusion: These findings support the hypothesis that LFR rTMS could be as effective as HFL rTMS and more suitable for patients with a higher anxiety degree, particularly in bipolar patients.

show abstract

Repetitive Transcranial Magnetic Stimulation (rTMS) in the treatment of Panic Disorder (PD) with comorbid major depression

Cited by 65 publications

References 14 publications

Low-Frequency rTMS over Right Dorsolateral Prefrontal Cortex in the Treatment of Resistant Depression: Cognitive Improvement Is Independent from Clinical Response, Resting Motor Threshold Is Related to Clinical Response

Low-Frequency rTMS over Right Dorsolateral Prefrontal Cortex in the Treatment of Resistant Depression: Cognitive Improvement Is Independent from Clinical Response, Resting Motor Threshold Is Related to Clinical Response

Transcranial magnetic stimulation and transcranial direct current stimulation appear to be safe neuromodulatory techniques useful in the treatment of anxiety disorders and other neuropsychiatric disorders

A Symptom-Specific Analysis of the Effect of High-Frequency Left or Low-Frequency Right Transcranial Magnetic Stimulation over the Dorsolateral Prefrontal Cortex in Major Depression

Contact Info

Product

Resources

About