Safety and Efficacy of Accelerated Repetitive Transcranial Magnetic Stimulation Protocol in Elderly Depressed Unipolar and Bipolar Patients

Jodoin, Véronique Desbeaumes; Miron, Jean‐Philippe; Lespérance, Paul

doi:10.1016/j.jagp.2018.10.019

Cited by 45 publications

(34 citation statements)

References 61 publications

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“…Indeed, it is supposed that cortical atrophy of the frontal lobe and higher rate of somatic symptoms are reasons for the fewer efficacy of rTMS in late-life depression [ 57 , 59 ]. Nevertheless, an accelerated rTMS protocol was shown to be more efficient in older depressed people (> 60 years) [ 60 ]. Recently, a trial with deep-rTMS provided promising results [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

Current clinical practice of electroconvulsive therapy and repetitive transcranial magnetic stimulation in psychiatry, a German sample

Timäus

Vogelgsang

Kis

et al. 2020

Eur Arch Psychiatry Clin Neurosci

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The purpose of the study was to evaluate the current clinical practice of Electroconvulsive Therapy and Repetitive Transcranial Magnetic Stimulation in German psychiatry. Case-based data (> 1.000.000 cases) were collected according to §21 of the German hospital remuneration law from January 2015 to December 2017. The study cohort comprises approximately 35–40% of the annual psychiatric cases and hospitals in Germany. Frequency of ECT and rTMS cases were investigated considering main diagnoses according to ICD-10 and treatment settings (inpatient vs. day-care). ECT cases with short-term hospitalization (≤ 4 days) were supposed to be maintenance ECT cases. A linear regression analysis was conducted to estimate trends in the use of ECT and rTMS. Different groups were compared using Chi-square tests. ECT and rTMS cases appear to increase in total during the observation period possibly due to facilities newly introducing ECT and rTMS but also to increased frequency of treatments. Both treatments were rarely performed in day-care settings (0.89% and 11.25%). ECT was performed in 1.72% of all cases with affective disorders and in 1.48% with major depressions, respectively. Age ≥ 65 years, females, severe and psychotic depression were significantly associated with a higher rate of ECT cases. > 40% of all ECT cases were possibly maintenance ECT cases. Only 0.60% of these were performed in day- care settings. rTMS was primarily performed in major depression (86,7% of all rTMS cases). This study suggests a growing demand for ECT and rTMS. Nevertheless, the use of ECT is still low compared to the high prevalence of treatment resistant depression. The use of rTMS is even lower and seems to be restricted to specialized institutions. Maintenance ECT is frequently carried out in an inpatient setting. Limitations of this study are the case- and group-based analysis, missing data on outpatient services and treatment sessions per case. Therefore, the database is not necessarily representative for the entire German healthcare system. Further studies are needed to verify the presented findings and should address the feasibility of ambulatory and day-care ECT services.

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Section: Discussionmentioning

confidence: 99%

Current clinical practice of electroconvulsive therapy and repetitive transcranial magnetic stimulation in psychiatry, a German sample

Timäus

Vogelgsang

Kis

et al. 2020

Eur Arch Psychiatry Clin Neurosci

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“…Desbeaumes and colleagues 31 included, in their retrospective study, 19 older adults with LLD with a mean age of 71.0 years (SD 8.3) treated with HF‐rTMS at left DLPFC (20 Hz). Five older adults (26.3%) reported AE such as headaches, local sensitivity and fatigue.…”

Section: Resultsmentioning

confidence: 99%

Adverse events of repetitive transcranial magnetic stimulation in older adults with depression, a systematic review of the literature

Overvliet

Jansen

Balkom

et al. 2020

Int J Geriat Psychiatry

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Objective: In the last decade, repetitive transcranial magnetic stimulation (rTMS) has been introduced as a non-invasive neuromodulation therapy for depression. Little is known, however, about (serious) adverse events (AE) of rTMS in older adults with a depression. In this article, we want to study what is known about (serious) AE of rTMS in older adults (>60 years) with late-life depression (LLD). Methods: A systematic search has been performed according to the PRISMA guidelines in PubMed, EMBase and PsycInfo. We have screened 622 articles for eligibility. Eleven studies, evaluating 353 patients in total, were included in this review. Results: AE were reported in 12.4% of the older adults with a LLD treated with rTMS, serious AE in 1.5%. Headache (6.9%) and discomfort at the stimulation site (2.7%) are the most commonly reported AE. Serious AE reported are: psychiatric hospitalization (three times), a combination of posterior vitreous detachment and retinal tear, and increased suicide ideation (both once). Conclusions: rTMS in older adults with LLD was concluded overall to be safe due to the low frequency of AE reported in trials and observational studies. In case-reports, however, more serious AE have been described. To tailor use of rTMS in older adults with LLD, more research is needed in larger samples to optimize tolerance.

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“…A retrospective analysis on 30 twice‐daily sessions of 20‐Hz HFL for TRD compared the response rates of accelerated rTMS between young and older adults ( N = 73; n = 19 ≥60 years; n = 54 <60 years). The authors reported significant clinical improvements in both groups, with the ≥60 year group reporting greater improvement than the young subjects, with more responders and remitters among older subjects …”

Section: Cost‐effectiveness In Rtms For Mddmentioning

confidence: 93%

“…The authors reported significant clinical improvements in both groups, with the ≥60 year group reporting greater improvement than the young subjects, with more responders and remitters among older subjects. 53 A clinical trial examining accelerated rTMS (N = 58; HFL 3 times per day, 3 days in week 1, 3 treatments over 2 days in weeks 2 and 3 treatments on a single day in week 3) compared with daily rTMS (n = 57; 5 days per week for 4 weeks) found no significant differences in remission or response rates between the two groups. 54 In a retrospective study, treatment outcomes of 36 patients with MDD who received 30 sessions of 10-Hz HFL with either twicedaily (n = 17) or daily (n = 19) rTMS, the authors reported a trend toward greater response rate in the twice-daily group (82.4%) compared with the once-daily group (52.6%).…”

Section: Accelerated Protocols: Can Response and Remission Be Achievementioning

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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Safety and Efficacy of Accelerated Repetitive Transcranial Magnetic Stimulation Protocol in Elderly Depressed Unipolar and Bipolar Patients

Cited by 45 publications

References 61 publications

Current clinical practice of electroconvulsive therapy and repetitive transcranial magnetic stimulation in psychiatry, a German sample

Current clinical practice of electroconvulsive therapy and repetitive transcranial magnetic stimulation in psychiatry, a German sample

Adverse events of repetitive transcranial magnetic stimulation in older adults with depression, a systematic review of the literature

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

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