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A 6-month follow-up study on response and relapse rates following an acute trial of repetitive transcranial magnetic stimulation in patients with major depression

Published online by Cambridge University Press:  04 September 2020

Chiara Arici
Affiliation:
Department of Mental Health and Addiction, ASST Vimercate, Vimercate, Italy
Beatrice Benatti
Affiliation:
Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Department of Mental Health, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy Department of Health Sciences, ‘Aldo Ravelli’ Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan Medical School, Milan, Italy
Rita Cafaro
Affiliation:
Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Department of Mental Health, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy
Laura Cremaschi
Affiliation:
Department of Mental Health and Addiction, ASST Papa Giovanni XXIII, Bergamo, Italy
Luca Degoni
Affiliation:
Department of Psychiatry, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
Sara Pozzoli
Affiliation:
Department of Psychiatry, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
Lucio Oldani
Affiliation:
Department of Psychiatry, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
Laura Molteni
Affiliation:
Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Department of Mental Health, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy
Federica Giorgetti
Affiliation:
Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Department of Mental Health, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy
Alberto Priori
Affiliation:
Department of Health Sciences, ‘Aldo Ravelli’ Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan Medical School, Milan, Italy Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
Caterina Viganò
Affiliation:
Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Department of Mental Health, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy
Bernardo Dell’Osso
Affiliation:
Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Department of Mental Health, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy Department of Health Sciences, ‘Aldo Ravelli’ Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan Medical School, Milan, Italy Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
Corresponding

Abstract

Background

Little is known about the post-acute effects of repetitive transcranial magnetic stimulation (rTMS) in patients with major depression. The present study focused on the 6-month follow-up of a sample of patients with major depression, after the completion of an acute 4 weeks rTMS trial, with the aim of evaluating response (in terms of sustained and late response) and relapse rates.

Methods

Following the completion of an acute trial of rTMS (T0-T4), 31 drug-resistant depressed patients (bipolar or unipolar) entered a naturalistic follow-up period of 6 months, with three timepoints (T5, T6, and T7) during which they were assessed with the Hamilton Depression Rating Scale and the Young Mania Rating Scale.

Results

Results showed that in the 6 months following an acute transcranial magnetic stimulation (TMS) trial, a higher rate of late responders was observed among previously acute TMS nonresponders (63.64%, 7 out of 11) compared to the rate of relapse among those who had acutely responded to TMS (10%, 2 out of 20). In addition, an overall high rate of maintained response (90%) was observed.

Conclusion

Present findings seem to support the possibility of obtaining a clinical response also after the end of an acute TMS trial in patients with major depression. The concomitant low rate of relapse observed at the end of follow-up along with a high rate of maintained response provides further support to the post-acute efficacy of TMS. Nonetheless, further controlled studies, with larger samples and longer follow-up observation, are needed to confirm the reported results.

Type
Original Research
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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