Treatment of Vascular Depression Using Repetitive Transcranial Magnetic Stimulation

Jorge, Ricardo E.; Moser, David J.; Ación, Laura; Robinson, Robert G.

doi:10.1001/archgenpsychiatry.2007.45

Cited by 188 publications

(124 citation statements)

References 41 publications

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“…86 There are no RCTs of electroconvulsive therapy in stroke survivors with PSD; however, electroconvulsive therapy has been used as a last resort to treat refractory PSD. 83 Treatment should be started at the lowest effective energy levels, using pulsatile currents, increased spacing of treatments (2-5 days between treatments), and fewer treatments in an entire course (ie, 4-6).…”

Section: Management: Neuromodulationmentioning

confidence: 99%

Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Towfighi¹,

Ovbiagele²,

Husseini³

et al. 2017

Stroke

Self Cite

533

506

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Abstract-Poststroke depression (PSD) is common, affecting approximately one third of stroke survivors at any one time after stroke. Individuals with PSD are at a higher risk for suboptimal recovery, recurrent vascular events, poor quality of life, and mortality. Although PSD is prevalent, uncertainty remains regarding predisposing risk factors and optimal strategies for prevention and treatment. This is the first scientific statement from the American Heart Association on the topic of PSD. Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statements Oversight Committee and the American Heart Association's Manuscript Oversight Committee. Members were assigned topics relevant to their areas of expertise and reviewed appropriate literature, references to published clinical and epidemiology studies, clinical and public health guidelines, authoritative statements, and expert opinion. This multispecialty statement provides a comprehensive review of the current evidence and gaps in current knowledge of the epidemiology, pathophysiology, outcomes, management, and prevention of PSD, and provides implications for clinical practice. (Stroke. 2017;48:e30-e43.

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Section: Management: Neuromodulationmentioning

confidence: 99%

Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Towfighi¹,

Ovbiagele²,

Husseini³

et al. 2017

Stroke

Self Cite

533

506

View full text Add to dashboard Cite

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“…In both studies, the nimodipine group presented a greater response. Two studies evaluated TMS efficacy for VaD, one study was small, open-label, with only 11 subjects; 23 while the other 24 was a randomized, shamcontrolled trial with 92 patients. In the pilot study, five of 11 patients achieved response, while in the larger trial active TMS was superior than sham TMS.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding statistics, three studies reported an "intention-totreat" analysis. Narushima et al 32 reported a complete case analysis, and data are unclear in the study by Salloway et al 20 Also, one study 24 specified one primary endpoint a priori; two studies performed exploratory analyses; 20,32 and the nimodipine studies, although specifying their endpoints a priori, defined in advance 14 endpoints, considering specially the positive findings in their discussion and results, which is an evidence of selective reporting bias. Finally, it should be underscored that in the study by Salloway et al 20 a sub-sample of a larger controlled trial was analyzed.…”

Section: Internal Validitymentioning

confidence: 99%

Therapeutic interventions for vascular depression: a systematic review

Brunoni

Benseñor

Alves

2011

Rev. Bras. Psiquiatr.

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Objective: Vascular depression (VaD) hypothesis supports a bidirectional relationship between cerebrovascular risk factors (CRFs) and depression. We examined whether such concept is appropriate for clinical interventions; i.e., whether treating depressive symptoms has an impact on cerebrovascular risk and vice-versa. Method: Systematic review on interventional studies published from October-1997 to April-2010 on MEDLINE and other databases. Search terms were "depressive disorder" (MeSH), "cerebrovascular disorders" (MeSH), and a batch of highly accurate terms to search for experimental and quasi-experimental trials. We used a structured questionnaire to assess the adequacy of the VaD criteria used for vascular, depression, neuroimaging, and neuropsychological features, as well as the main results of each study. Results: Of the 357 retrieved studies, 12 met our eligibility criteria. These studies adequately reported depression criterion, moderately reported neuroimaging and neuropsychological criteria, and showed severe flaws in vascular assessment. Efficacy trials suggested that nimodipine, transcranial magnetic stimulation, carotid stent placement, and citalopram were effective for VaD. Exploratory studies suggested that white-matter hyperintensities and global vascular risk are predictors of poor response. Although the low quality of the studies hinders the findings' generalization, studies of higher validity support the VaD concept for interventions. Conclusion: VaD seems to be a useful concept for clinical interventions; however, further trials should refine CRFs criteria to assess its impact on antidepressant efficacy. ©2011 Elsevier Editora Ltda. All rights reserved. DesCRIpToRs:Major depressive disorder; Cerebrovascular disorders; Depression; Review; Therapeutics. ReVIeW ARTICLe Therapeutic interventions for vascular depression: a systematic review Intervenções terapêuticas para a depressão vascular: uma revisão sistemática ResumoObjetivo: A hipótese da depressão vascular (DV) defende uma correlação bidirecional entre fatores de risco cerebrovasculares e depressão. Nós investigamos se este conceito é apropriado para intervenções clínicas -ou seja, se o tratamento de sintomas depressivos modifica o risco cerebrovascular e vice-versa. Método: Revisão sistemática de estudos intervencionistas publicados entre outubro/1997 e abril/2010 nos bancos de dados MEDLINE e outros. Os unitermos procurados foram "depressive disorder" (MeSH), "cerebrovascular disorders" (MeSH) e um conjunto de termos altamente acurados para procurar por estudos experimentais ou quasi-experimentais. Nós usamos um questionário estruturado para examinar se os critérios de DV usados para depressão, vascular, neuroimagem e neuropsicológicos foram adequados, e os resultados principais de cada estudo. Resultados: De 357 artigos obtidos, 12 foram inclusos. Eles relataram adequadamente o critério de depressão, moderadamente os critérios neuropsicológicos e de neuroimagem e apresentaram erros graves no critério vascular. Estudos de eficác...

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“…A recent study showed that ten to 15 sessions of rTMS applied on the left DLPFC at a frequency of 10Hz, and an intensity of 110% MT was associated with significant reduction of depressive symptoms by 30% and a remission rate of 10% as compared to placebo intervention. Mild and few adverse effects such as headache were reported [131][132][133][134][135][136][137][138][139][140][141][142][143][144][145][146][147][148][149] . Another advantage of the use of rTMS is the improvement in executive functions by rTMS 150,151 .…”

Section: Mdd In the Rehabilitation Settingmentioning

confidence: 99%

Neuromodulation approaches for the treatment of major depression: challenges and recommendations from a working group meeting

Brunoni

Teng

Correa³

et al. 2010

Arq. Neuro-Psiquiatr.

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The use of neuromodulation as a treatment for major depressive disorder (MDD) has recently attracted renewed interest due to development of other non-pharmacological therapies besides electroconvulsive therapy (ECT) such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), and vagus nerve stimulation (VNS). Method: We convened a working group of researchers to discuss the updates and key challenges of neuromodulation use for the treatment of MDD. results: The state-of-art of neuromodulation techniques was reviewed and discussed in four sections: [1] epidemiology and pathophysiology of MDD; [2] a comprehensive overview of the neuromodulation techniques; [3] using neuromodulation techniques in MDD associated with non-psychiatric conditions; [4] the main challenges of neuromodulation research and alternatives to overcome them. Discussion: ECT is the first-line treatment for severe depression. TMS and tDCS are strategies with a relative benign profile of side effects; however, while TMS effects are comparable to antidepressant drugs for treating MDD; further research is needed to establish the role of tDCS. DBS and VNS are invasive strategies with a possible role in treatment-resistant depression. In summary, MDD is a chronic and incapacitating condition with a high prevalence; therefore clinicians should consider all the treatment options including invasive and non-invasive neuromodulation approaches. Key words: comprehensive review, major depressive disorder, ECT, TMS, clinical guidelines.Estratégias de neuromodulação para o tratamento da depressão maior: desafios e recomendações de uma força-tarefa rEsuMo O uso de técnicas de neuromodulação para o tratamento do transtorno depressivo maior (TDM) tem despertado um renovado interesse nos últimos anos com o desenvolvimento de outras intervenções não-farmacólogicas além da eletroconvulsoterapia (ECT), como a estimulação magnética transcraniana (EMT), a estimulação transcraniana por corrente continua (ETCC), a estimulação cerebral profunda (DBS) e a estimulação de nervo vago (VNS). Método: Nós organizamos um grupo de trabalho com vários pesquisadores para discutir os avanços recentes e os principais desafios para o uso da neuromodulação no tratamento os principais desafios da pesquisa na neuromodulação e alternativas para superá-los. Discussão: ECT é o tratamento de primeira linha para depressão grave. EMT e ETCC são estratégias com um perfil benigno de efeitos adversos; contudo, enquanto os efeitos da EMT são comparáveis ao das drogas antidepressivas para o tratamento da TDM, a eficácia da ETCC ainda precisa ser estabelecida por mais pesquisas clínicas. DBS e VNS são intervenções invasivas com um papel possível para a depressão refratária. Em resumo, TDM é uma condição crônica, incapacitante e de alta prevalência; portanto na prática clínica todas as opções de tratamento possíveis, incluindo as farmacológicas e não-farmacológicas, devem ser consideradas. Palavras-chave: artigo de revisão, tra...

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Treatment of Vascular Depression Using Repetitive Transcranial Magnetic Stimulation

Abstract: To our knowledge, this is the first controlled trial that demonstrates the efficacy of rTMS among geriatric patients with VD. Older age and smaller frontal gray matter volumes were associated with a poorer response to rTMS.

Cited by 188 publications

References 41 publications

Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Therapeutic interventions for vascular depression: a systematic review

Neuromodulation approaches for the treatment of major depression: challenges and recommendations from a working group meeting

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