TY - JOUR
T1 - Low frequency rTMS inhibits the anti-depressive effect of ECT
T2 - A pilot study
AU - Buchholtz, Poul Erik
AU - Ashkanian, Mahmoud
AU - Hjerrild, Simon
AU - Hauptmann, Line Kirstine
AU - Devantier, Torben Albert
AU - Jensen, Paulina
AU - Wissing, Sanne
AU - Thorgaard, Mette
AU - Bjerager, Lærke
AU - Saugberg, Julie Lund
AU - Alrø, Anja
AU - Speed, Maria
AU - Brund, René Børge Korsgaard
AU - Videbech, Poul
PY - 2020/12/27
Y1 - 2020/12/27
N2 - Objective: Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex has been shown to have a statistically and clinically significant anti-depressant effect. The present pilot study was carried out to investigate if right prefrontal low-frequency rTMS as an add-on to electroconvulsive therapy (ECT) accelerates the anti-depressant effect and reduces cognitive side effects. Methods: In this randomised, controlled, double-blind study, thirty-five patients with major depression were allocated to ECTþplacebo or ECTþlow-frequency right prefrontal rTMS. The severity of depression was evaluated during the course using the Hamilton scale for depression (the 17-item as well as the 6-item scale) and the major depression inventory (MDI). Furthermore, neuropsychological assessment of cognitive function was carried out. Results: The study revealed no significant difference between the two groups for any of the outcomes, but with a visible trend to lower scores for MDI after treatment in the placebo group. The negative impact of ECT on neurocognitive functions was short-lived, and scores on logical memory were significantly improved compared to baseline 4 weeks after last treatment. The ECT-rTMS group revealed generally less impairment of cognitive functions than the ECT-placebo group. Conclusion: The addition of low-frequency rTMS as an add-on to ECT treatment did not result in an accelerated response. On the contrary, the results suggest that low-frequency rTMS could inhibit the anti-depressant effect of ECT.
AB - Objective: Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex has been shown to have a statistically and clinically significant anti-depressant effect. The present pilot study was carried out to investigate if right prefrontal low-frequency rTMS as an add-on to electroconvulsive therapy (ECT) accelerates the anti-depressant effect and reduces cognitive side effects. Methods: In this randomised, controlled, double-blind study, thirty-five patients with major depression were allocated to ECTþplacebo or ECTþlow-frequency right prefrontal rTMS. The severity of depression was evaluated during the course using the Hamilton scale for depression (the 17-item as well as the 6-item scale) and the major depression inventory (MDI). Furthermore, neuropsychological assessment of cognitive function was carried out. Results: The study revealed no significant difference between the two groups for any of the outcomes, but with a visible trend to lower scores for MDI after treatment in the placebo group. The negative impact of ECT on neurocognitive functions was short-lived, and scores on logical memory were significantly improved compared to baseline 4 weeks after last treatment. The ECT-rTMS group revealed generally less impairment of cognitive functions than the ECT-placebo group. Conclusion: The addition of low-frequency rTMS as an add-on to ECT treatment did not result in an accelerated response. On the contrary, the results suggest that low-frequency rTMS could inhibit the anti-depressant effect of ECT.
KW - Electroconvulsive therapy (ECT)
KW - Keywords:
KW - Low frequency transcranial magnetic stimulation (rTMS)
KW - Randomized trial
KW - depression
UR - http://www.scopus.com/inward/record.url?scp=85091844919&partnerID=8YFLogxK
U2 - 10.1017/neu.2020.28
DO - 10.1017/neu.2020.28
M3 - Journal article
C2 - 32713367
SN - 0924-2708
VL - 32
SP - 328
EP - 338
JO - Acta Neuropsychiatrica
JF - Acta Neuropsychiatrica
IS - 6
ER -