Low frequency rTMS inhibits the anti-depressive effect of ECT: A pilot study

Poul Erik Buchholtz*, Mahmoud Ashkanian, Simon Hjerrild, Line Kirstine Hauptmann, Torben Albert Devantier, Paulina Jensen, Sanne Wissing, Mette Thorgaard, Lærke Bjerager, Julie Lund Saugberg, Anja Alrø, Maria Speed, René Børge Korsgaard Brund, Poul Videbech

*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

5 Citations (Scopus)

Abstract

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.

Original languageEnglish
JournalActa Neuropsychiatrica
Volume32
Issue6
Pages (from-to)328-338
Number of pages11
ISSN0924-2708
DOIs
Publication statusPublished - 27 Dec 2020

Keywords

  • Electroconvulsive therapy (ECT)
  • Keywords:
  • Low frequency transcranial magnetic stimulation (rTMS)
  • Randomized trial
  • depression

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