A randomized trial of the anti-depressant effects of low- and high-frequency transcranial magnetic stimulation in treatment-resistant depression
Abstract
Background The majority of studies investigating the effectiveness of repetitive transcranial magnetic stimulation (rTMS) as a treatment for major depression have focused on high-frequency rTMS to the left prefrontal cortex (HFL-rTMS). In addition, low-frequency right prefrontal rTMS (LFR-rTMS) has also been shown to have antidepressant properties. To date only a small number of studies have directly compared the efficacy of these two approaches. Methods The aim of this study, therefore, was to investigate further whether LFR-rTMS is as effective as HFL-rTMS in the treatment of major depression. Twenty-seven patients were randomized to one of two treatment arms (HFL-rTMS or LFR-rTMS) for 3 weeks with a possible 1-week extension. Non-responders were offered the opportunity of crossing over to the other treatment type. Stimulation parameters for HFL-rTMS were 30 stimulation trains of 5 s duration at 100% of the resting motor threshold (RMT); for LFR-rTMS, stimulation was applied in four trains of 180 s duration (30 s inter-train interval) at 110% of the RMT. Stimulation was provided 5-week days per week. Results There were significant improvements seen from baseline to end point irrespective of group and on all clinical outcome measures. In addition, there was no deterioration in any of the measures used to assess cognitive change, and significant improvements were seen on measures of immediate verbal memory and verbal fluency. Conclusions HFL-rTMS and LFR-rTMS appear to be equ…
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Cognitive improvements following rTMS have been observed in younger adults with depression across various domains including learning and memory, attention, executive function, and psychomotor processing speed.
“Cognitive improvements following rTMS have been observed in younger adults with depression across various domains including learning and memory,16–18 attention, 19 executive function19–24 and psychomotor processing speed.”
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Self-citation
- Authors
- Fitzgerald, P. B., Hoy, K., Daskalakis, Z. J., & Kulkarni, J.
- Affiliations
- The Alfred Hospital (AU)
- Centre for Addiction and Mental Health (CA)
- Corresponding author
- Fitzgerald, Paul B.
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2009-03
- Volume
- 26
- Issue
- 3
- Pages
- 229-234
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- OpenAlex
- W2037559690
- Cited by
- 147
- References
- 19
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 3 · 2023: 7 · 2022: 12 · 2021: 9 · 2020: 9 · 2019: 11 · 2018: 8 · 2017: 5 · 2016: 7 · 2015: 5 · 2014: 8 · 2013: 11 · 2012: 14
- FWCI
- 5.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Health and Medical Research Council
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- repetitive transcranial magnetic stimulation, low-frequency rTMS, high-frequency rTMS, treatment-resistant depression, major depressive disorder, antidepressant effects, prefrontal cortex stimulation, cognitive side effects, verbal memory, verbal fluency, stimulation parameters
- MeSH terms
- Adult, Cognition, Major Depressive Disorder, Drug Resistance, Female, Humans, Male, Middle Aged, Remission Induction, Prefrontal Cortex, Diagnostic and Statistical Manual of Mental Disorders, Transcranial Magnetic Stimulation
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