The impact of high-frequency repetitive transcranial magnetic stimulation on executive functioning of drug-free patients with treatment-resistant depression

Abstract

OBJECTIVES:The aim of the present study was to examine the impact of 25 Hz high-frequency repetitive transcranial magnetic stimulation (rTMS) on neuropsychological testing in treatmentresistant depression patients who were receiving no other concomitant medications for the treatment. METHODS: A total of 19 patients with treatment-resistant depression and 20 healthy controls were included in the study. A 25 Hz, 1000 pulse stimulation was set at 100% of the motor threshold and delivered 20 times for 2 s with 30 s intervals as 20 sessions to the depression group, and sham treatment was applied to the control group. Brief Psychiatric Rating Scale (BPRS), Stroop task, trail-making test (TMT), and Wisconsin card sorting test (WCST) were performed both before and 3 days after the rTMS treatment. Seventeen-item Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory (BDI) were obtained at baseline and after the rTMS treatment, as well. RESULTS: After the rTMS treatment, 52.6% (10 of 19 patients) met the response criteria (>50% improvement in HAMD score), with 5 (26.3%) patients meeting the criteria for remission of depression (HAMD score ≤ 8). None of the patients had a worsened HAMD score at the end of treatment. Reflecting the antidepressant effect of rTMS treatment, the mean BDI score, BPRS score, and Stroop task scores significantly differed following the treatment (p < .001, p < .001, and p = .017, respectively). TMT score difference did not reach statistical significance, whereas WCST scores showed significance in "correct responses" and "perseverative errors" categories (p < .05, and p < .05, respectively). None of the test scores at the end of rTMS treatment showed a significant difference when compared to baseline scores for the control group (p > .05, for all). CONCLUSIONS: Results suggest that rTMS can be used as a beneficial treatment option to ameliorate cognitive functions, especially executive functions. Patients had an improvement in depressive symptoms with the rTMS treatment without any concomitant medication, as well. Therefore, improvement in cognitive performance might be associated with improvement in depressive symptoms. ARTICLE HISTORY

Identification of the sociodemographic and clinical characteristics of the patients who have undergone transcranial magnetic stimulation in a psychiatry clinic: A retrospective descriptive design

“…Thus, it has been known that TMS treatment is applied for 20 sessions and its effect emerges after 2 weeks. 16,17 Another determination of our study was that most of the individuals undergoing TMS did not have any physical discomfort in addition to the psychiatric diagnosis. TMS is a reliable application due to its noninvasive nature.…”

“… Obtains the consent of the patients and their relatives. Provides information to the patients and their families about TMS. Gives instructions to the patients about possible side effects (pain in the head and face, dizziness, muscle pain, temporary deafness, cognitive changes, and seizure). Examines the patient's files and retrieves information regarding their diagnosis and treatment. Tells the patients the things that should be done before coming for treatment, such as the hair should be clean and no hair cream, gel, or spray should be used before coming for treatment. Tells the patients to remove their dentures, eyeglasses, and all jewelry, including hair clips and earrings. Offers to keep the valuable belongings of the patients safe. Tells the patients to wear a swimming cap. Tells the patients to empty their bladders 16,17 …”

“… Evaluates whether the patient has suffered any adverse effects (e.g., pain in the head and face, dizziness, muscle pains, temporary deafness, cognitive changes, seizure). Measures the patient's blood pressure and pulse rate and records them. Schedules an appointment for the next TMS treatment session. Reminds the patient to bring a swimming cap to each session (to prevent sliding of the palette on the scalp due to hairy skin) 16,17 …”

“…• Reminds the patient to bring a swimming cap to each session (to prevent sliding of the palette on the scalp due to hairy skin). 16,17…”

Neural correlates of cue‐ and stress‐induced craving in gambling disorders: implications for transcranial magnetic stimulation interventions

“…Importantly, only few studies have investigated whether DLPFC rTMS may help addressing a number of other critical, disabling behavioral hallmarks of the addiction, such as impaired executive functioning and emotion regulation (Table ). In this regard, useful insights may come from the depression research community indicating that high‐frequency rTMS of the DLPFC improves executive functions and cognitive control over negative emotions (Lantrip et al ., ; Möbius et al ., ; Şalçini et al ., ). Proving that DLPFC rTMS in patients with addictions can address also these deficits can be as important as reducing craving, as these aspects are related, and also because impaired executive functioning and cognitive control over emotion may represent important transdiagnostic phenotypes across addictions and other psychiatric disorders.…”