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Cited by 97Transcranial Magnetic Stimulation StudiesHeart Rate Variability and Autonomic ControlTreatment of Major Depression

Modulation of cardiac autonomic functions in patients with major depression treated with repetitive transcranial magnetic stimulation

Udupa, Kaviraja, Sathyaprabha, T.N., Thirthalli, Jagadisha, Kishore, K.R., Raju, T.R., Gangadhar, B.N.·2007·Journal of Affective Disorders
DOI 10.1016/j.jad.2007.04.002
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Abstract

Background Sub clinical cardiac autonomic imbalance is associated with depression. Clinical improvement produced by antidepressant therapy might alter this autonomic balance.Objectives To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) therapy on autonomic functions measured by heart rate variability (HRV) in depression patients and compare it with selective serotonin re-up-take inhibitors (SSRI) therapy.Methods Consecutive drug-naïve patients of major depression based on DSM-IV-TR were recruited in this study (n=67). Basal Hamilton depression-rating scale (HDRS) and measures of cardiac autonomic function were recorded and compared with those after two weeks of therapy with rTMS (n=27) and one month after SSRI therapy (n=25).Results Both therapies produced comparable and significant reduction in HDRS scores. HRV measures indicated that rTMS produced significantly greater reduction in the sympathetic: parasympathetic ratio suggesting improvement in sympathovagal balance. Conventional cardiac autonomic function tests did not differentiate the two therapy effects.Conclusions rTMS not only produced antidepressant effects but also ''corrected'' the autonomic imbalance. SSRI was systemically administered and hence by direct cardiac effect, may have masked cardiac effects that would have occurred by the improvement in depression. Alternatively, the neurophysiological ''correction'' with drug therapy may have longer latency, just as with the therapeutic effects.

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  • MDD is associated with abnormally elevated sympathetic function and reduced parasympathetic tone on heart rate under resting conditions.

    “Several studies have reported evidence for abnormally elevated sympathetic function in MDD, coupled with reduced parasympathetic tone on heart rate under resting conditions (35, 36).”

    From Localization of Dysfunction in Major Depressive Disorder: Prefrontal Cortex and Amygdala (2011) · cites this paper as [36]

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Authors
Udupa, K., Sathyaprabha, T. N., Thirthalli, J., Kishore, K. R., Raju, T. R., & Gangadhar, B. N.
Affiliations
National Institute of Mental Health and Neurosciences (IN)
Corresponding author
Sathyaprabha, T.N.
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2007-12
Volume
104
Issue
1-3
Pages
231-236
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2007.04.002
OpenAlex
W2043812429
Cited by
97
References
25
Citations by year
2026: 6 · 2025: 5 · 2024: 2 · 2023: 7 · 2022: 8 · 2021: 8 · 2020: 4 · 2019: 4 · 2018: 6 · 2017: 3 · 2016: 5 · 2015: 8 · 2014: 5 · 2013: 4 · 2012: 5
FWCI
2.34
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • National Institute of Mental Health
Topics
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
major depressive disorder, repetitive transcranial magnetic stimulation, heart rate variability, cardiac autonomic function, sympathovagal balance, selective serotonin reuptake inhibitors, antidepressant treatment, autonomic imbalance
MeSH terms
Adult, Autonomic Nervous System, Combined Modality Therapy, Major Depressive Disorder, Female, Heart Rate, Humans, Male, Vagus Nerve, Selective Serotonin Reuptake Inhibitors, Transcranial Magnetic Stimulation

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