Right frontal lobe slow frequency repetitive transcranial magnetic stimulation (SF r-TMS) is an effective treatment for depression: a case-control pilot study of safety and efficacy

Abstract

Major depression may result from decreased left frontal lobe function with respect to the right. Fast frequency repetitive transcranial magnetic stimulation (FF r-TMS) excites the underlying cortex whereas slow frequency repetitive transcranial magnetic stimulation (SF r-TMS) causes cortical inhibition. Left frontal FF r-TMS attenuates major depression whereas the inhibitory eVects of right frontal SF r-TMS are unknown. This study tested the hypothesis that right frontal SF r-TMS would treat depressed patients with minimal eVect on controls.A psychiatrist administered the Beck depression inventory and Hamilton D depression rating scales to eight depressed patients and six controls before and after the treatment protocol. Eight sessions of 100 right frontal lobe SF r-TMS were given at motor threshold and 0.5 Hz over a 6 week period.No adverse outcomes were noted in either group. A significant antidepressant eVect was noted in depressed patients on the Beck and Hamilton D depression rating scales (p<0.05). No change on either scale was noted in the controls.In conclusion right frontal lobe SF r-TMS is a safe, non-invasive treatment for major depression that deserves further investigation. (J Neurol Neurosurg Psychiatry 1999;67:113-115)

Estimulação Magnética Transcraniana na depressão: resultados obtidos com duas aplicações semanais

“…Three patients had a pattern considered as remission, 15 with a punctuation below 8 in the same scale.…”

“…In our study, we have initially used biweekly applications, as there were previous reports in the literature which had used this protocol. 15 As there was an improvement, we have chosen to augment it through the increase in the frequency of applications in future studies. This study was discontinued at this point precisely due to its positive results, which authorize and encourage us to use more frequent stimulations.…”

“…However, in that study they had not set the application days; it was only said that the treatment was composed of 8 sessions, lasting for 6 weeks, and there was no interval longer than 1 week between the applications and no more than two weekly applications were performed. In our protocol, which is similar to that of Menkes, 15 we have pre-established two weekly sessions, with a three-day interval between them. Except for this, we have used the same parameters of his study (described below).…”

Depressive symptoms and motor performance in the elderly: a population based study

“…Menkes et al 27 observed that there is a reduced activity of the frontal lobe, which results in impairment of planning activities in depressed individuals. However, the main point in the association of depression with motor performance appears to be in the deficiency of the neurotransmitter dopamine.…”

O uso da estimulação magnética transcraniana de baixa frequência no tratamento da depressão no Hospital Universitário de Brasília: achados preliminares

“…A estimulação de baixa frequência, por outro lado, diminui a atividade cerebral 9 . Menkes et al 10 sugeriram que a depressão maior deve ser o resultado de uma diminuição da função do lobo frontal esquerdo em relação ao direito. Baseados nesta hipótese, propuseram o tratamento com a estimulação magnética transcraniana de baixa frequência sobre o cór-tex frontal direito, com intuito de diminuir a atividade naquela área.…”