High frequency repetitive transcranial magnetic stimulation treatment for major depression: dissociated effects on psychopathology and neurocognition
Open accessAbstract
Objectives This open-label pilot study explored the effects of a course of accelerated high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) on two neurocognitive domains (decision-making and impulse control) in patients with major depressive disorder (MDD). Methods Participants with MDD and a treatment resistant major depressive episode (n=24) underwent twice-daily HF-rTMS targeted at the left dorsolateral prefrontal cortex (lDLPFC) over two weeks. Psychopathology was assessed by clinician-administered and self-reported measures of depression and anxiety; decision-making was assessed by the Iowa Gambling Task, the Balloon Analog Risk Task and the Game of Dice Task; impulse control was assessed by the Stroop Color-Word Task, the Continuous Performance Task and the Stop-Signal Task. Results Depression and anxiety scores significantly improved from pre-post HF-rTMS treatment. However, none of the decision-making or impulse control variables of interest changed significantly from pre-post HF-rTMS. Moreover, there was no correlation between changes in psychopathological symptoms and in neurocognition. Limitations This is a moderately sized open label trial, and the confounds of ongoing psychotropics and illness chronicity can not be excluded in this treatment resistant sample. Conclusions There is dissociation between acute symptomatic benefit after a course of accelerated HF-rTMS applied to the lDLPFC in treatment resistant MDD and performance on tests of decision making and impulse control. Though rTMS appears cognitively safe, additional research is warranted to understand this potential dissociation and its putative clinical implications.
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There is some indication of increased adherence and faster treatment response for accelerated iTBS compared to conventional rTMS.
“with some indication of increased adherence and faster treatment response compared to conventional rTMS [22–25].”
From A phase I trial of accelerated intermittent theta burst rTMS for amnestic MCI (2024) · cites this paper as [22]
The rTMS Procedure passage (page unavailable) describes twice-daily high-frequency rTMS, and Psychopathology pre-post HF-rTMS reports symptom improvement by week 3. Neither passage compares accelerated iTBS with conventional rTMS or reports comparative adherence or response speed. Searches for iTBS, adherence, and faster comparative response found no passage addressing that claim. (LLM, conf=0.77)
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- Authors
- Tovar-Perdomo, S., McGirr, A., Van den Eynde, F., Rodrigues dos Santos, N., & Berlim, M. T.
- Affiliations
- Douglas Mental Health University Institute (CA)
- University of British Columbia (CA)
- Corresponding author
- Berlim, Marcelo T.
- ORCID
- McGirr, Alexander
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2017-08
- Volume
- 217
- Pages
- 112-117
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2605066774
- Cited by
- 18
- References
- 64
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 1
- FWCI
- 1.09
- Type
- journal article
- Language
- en
- Open access
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- eScholarship@McGill (McGill) (submittedVersion)
- McGill-DEV
- Funders
- Fonds de recherche du Québec – Santé
- 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
- high-frequency repetitive transcranial magnetic stimulation, major depressive disorder, treatment-resistant depression, dorsolateral prefrontal cortex, decision-making, impulse control, neurocognitive function, psychopathology, anxiety, cognitive safety
- MeSH terms
- Adult, Depressive Disorder, Major, Major Depressive Disorder, Dissociative Disorders, Female, Humans, Iowa, Male, Middle Aged, Pilot Projects, Psychopathology, Prefrontal Cortex, Transcranial Magnetic Stimulation, Depressive Disorder, Treatment-Resistant
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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