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A randomized trial comparing repetitive transcranial magnetic stimulation given 3 days/week and 5 days/week for the treatment of major depression: is efficacy related to the duration of treatment or the number of treatments?

Published online by Cambridge University Press:  13 September 2011

C. Galletly ,
S. Gill ,
P. Clarke ,
C. Burton  and
P. B. Fitzgerald
C. Galletly*
Affiliation:
The Adelaide Clinic, Ramsay Health Care (SA) Mental Health Services, South Australia Discipline of Psychiatry, School of Medicine, The University of Adelaide, South Australia Northern Mental Health, Adelaide Health Service, South Australia
S. Gill
Affiliation:
The Adelaide Clinic, Ramsay Health Care (SA) Mental Health Services, South Australia
P. Clarke
Affiliation:
The Adelaide Clinic, Ramsay Health Care (SA) Mental Health Services, South Australia
C. Burton
Affiliation:
The Adelaide Clinic, Ramsay Health Care (SA) Mental Health Services, South Australia
P. B. Fitzgerald
Affiliation:
Monash Alfred Psychiatry Research Centre, The Alfred and Monash University School of Psychology and Psychiatry, Victoria, Australia
*
*Address for correspondence: Professor C. Galletly, Suite 13, The Adelaide Clinic Consulting Suites, 33 Park Tce, Gilberton 5081, Australia. (Email: cherrie.galletly@adelaide.edu.au)
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Abstract

Background

Repetitive transcranial magnetic stimulation (rTMS) has been shown to be an effective treatment for depression. However, there has been little research to determine optimal parameters for treatment.

Method

This study compared two rTMS treatment regimes for the treatment of major depression. Seventy-seven participants were randomized to either spaced or daily treatment. Spaced rTMS was given 3 days/week for 6 weeks (18 treatments in total) and daily rTMS was given 5 days/week for 4 weeks (20 treatments in total). All participants were assessed at baseline and after 4 weeks of treatment. Participants in the spaced treatment group were also assessed after 6 weeks of treatment. All participants were treated at 110% of the resting motor threshold with high-frequency rTMS (10 Hz) to the left dorsolateral prefrontal cortex (DLPFC) followed by low-frequency rTMS to the right DLPFC.

Results

Participants in the daily treatment group showed more improvement by week 4 than those in the spaced treatment group; however, both groups had similar improvement by treatment completion. There was significant improvement in both groups in ratings of depression and anxiety, with no significant differences between groups.

Conclusions

Our study indicates that the efficacy of rTMS is related to the number of treatments given and that spacing the treatments neither improves nor reduces efficacy.

Keywords

Antidepressantdorsolateral prefrontal cortexhigh-frequency stimulationneurostimulationtreatment service
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 5 , May 2012 , pp. 981 - 988
Copyright
Copyright © Cambridge University Press 2011

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