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Investigating the impact of adjunctive priming repetitive transcranial magnetic stimulation in late-life depression: a pilot single-blind randomized control study

Published online by Cambridge University Press:  11 August 2023

Kote L. Vidya ,
Shrikant Srivastava ,
Bhupendra Singh  and
Sujita K. Kar Open the ORCID record for Sujita K. Kar [Opens in a new window]
Kote L. Vidya
Affiliation:
Department of Geriatric Mental Health, King George’s Medical University, Lucknow, India
Shrikant Srivastava
Affiliation:
Department of Geriatric Mental Health, King George’s Medical University, Lucknow, India
Bhupendra Singh
Affiliation:
Department of Geriatric Mental Health, King George’s Medical University, Lucknow, India
Sujita K. Kar*
Affiliation:
Department of Psychiatry, King George’s Medical University, Lucknow, India
*
Corresponding author: Sujita K. Kar; Email: drsujita@gmail.com
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Abstract

Background

Conventional treatment methods have limited effectiveness in addressing late-life depression (LLD) that does not respond well. While a new approach called priming repetitive transcranial magnetic stimulation (rTMS) has shown promise in treating depression in adults, its effectiveness in LLD has not been explored. This study aimed to investigate the impact of priming rTMS on LLD.

Methods

This study investigated the effectiveness of priming rTMS in 31 patients with LLD who did not improve after an adequate trial of antidepressants. Patients were randomly assigned to receive either active priming rTMS or sham priming rTMS. Active priming rTMS was delivered over the right dorsolateral prefrontal cortex for 10 sessions, lasting 31 minutes each, over a period of 2 weeks.

Results

The group receiving active priming rTMS demonstrated greater improvements in scores on the Hamilton Rating Scale for Depression (p < 0.037; partial η2 0.141) and the Geriatric Depression Rating Scale (p < 0.045; partial η2 0.131) compared to the sham priming group, with a mild effect size. At the end of the second and fourth weeks, the priming rTMS group achieved a response rate of 50%, while the sham priming group had response rates of 26.7% and 6.7%, respectively. No adverse effects requiring intervention were observed.

Conclusion

Priming rTMS is well-tolerated for the treatment of LLD and not only reduces the severity of depression but also maintains the achieved response over time.

Keywords

Primingtranscranial magnetic stimulationlate-life depressionsafetyefficacy
Type
Original Research
Information
CNS Spectrums , Volume 29 , Issue 1 , February 2024 , pp. 76 - 82
Copyright
© The Author(s), 2023. Published by Cambridge University Press

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