Magnetic seizure therapy (MST) for major depressive disorder
Open accessAbstract
Electroconvulsive therapy (ECT) is effective for major depressive disorder (MDD) but its effects on memory limit its widespread use. Magnetic seizure therapy (MST) is a potential alternative to ECT that may not adversely affect memory. In the current trial, consecutive patients with MDD consented to receive MST applied over the prefrontal cortex according to an open-label protocol. Depressive symptoms and cognition were assessed prior to, during and at the end of treatment. Patients were treated two to three times per week with high-frequency MST (i.e., 100 Hz) (N = 24), medium frequency MST (i.e., 60 or 50 Hz) (N = 26), or low-frequency MST (i.e., 25 Hz MST) (N = 36) using 100% stimulator output. One hundred and forty patients were screened; 86 patients with MDD received a minimum of eight treatments and were deemed to have an adequate course of MST; and 47 completed the trial per protocol, either achieving remission (i.e., 24-item Hamilton Rating Scale for Depression score <10 and a relative reduction of >60% at two consecutive assessments; n = 17) or received a maximum of 24 sessions (n = 30). High-frequency (100 Hz) MST produced the highest remission rate (33.3%). Performance on most cognitive measures remained stable, with the exception of significantly worsened recall consistency of autobiographical information and significantly improved brief visuospatial memory task performance. Under open conditions, MST led to clinically meaningful reduction in depressive symptoms in patients with MDD and produced minimal cognitive impairment. Future studies should compare MST and ECT under double-blind randomized condition.
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Emerging clinical evidence supports antidepressant effects of magnetic seizure therapy in treatment-resistant unipolar depression, and it may have efficacy comparable to electroconvulsive therapy.
“Emerging clinical evidence supports the antidepressant effects of MST in treatment-resistant unipolar depression, and it may have efficacy comparable to ECT. [17][18][19]”
From Magnetic seizure therapy is efficacious and well tolerated for treatment-resistant bipolar depression: An open-label clinical trial (2020) · cites this paper as [19]
A previously published large open-label trial of magnetic seizure therapy in treatment-resistant major depressive disorder used the same protocol as the current study with low, medium or high frequencies and prefrontal coil placement.
“Recently, we published the results of a large open-label clinical trial of MST in treatment-resistant major depressive disorder using the same protocol as the current study with low, medium or high frequencies and the stimulating coil placed over the prefrontal cortex.19”
From Magnetic seizure therapy is efficacious and well tolerated for treatment-resistant bipolar depression: An open-label clinical trial (2020) · cites this paper as [19]
In a recent larger-sample MST study in major depressive disorder, high-frequency (100 Hz) stimulation had higher antidepressant effects than moderate or low frequencies.
“Our recent study of MST in major depressive disorder with a much larger sample size showed that highfrequency (100 Hz) stimulation had higher antidepressant effects than moderate or low frequencies, 19 and it will be important for future research to determine whether this is also the case for patients with bipolar disorder.”
From Magnetic seizure therapy is efficacious and well tolerated for treatment-resistant bipolar depression: An open-label clinical trial (2020) · cites this paper as [19]
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- Authors
- Daskalakis, Z. J., Dimitrova, J., McClintock, S. M., Sun, Y., Voineskos, D., Rajji, T. K., Goldbloom, D. S., Wong, A. H. C., Knyahnytska, Y., Mulsant, B. H., Downar, J., Fitzgerald, P. B., & Blumberger, D. M.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- Duke University (US)
- University Health Network (CA)
- Epworth Hospital (AU)
- Corresponding author
- Daskalakis, Zafiris J.
- ORCID
- Venue
- Neuropsychopharmacology
- Published
- 2019-09-05
- Volume
- 45
- Issue
- 2
- Pages
- 276-282
- ISSN
- 0893-133X (ISSN-L)
- 1740-634X
- PMC
- PMC6901571
- OpenAlex
- W2972013619
- Cited by
- 92
- References
- 30
- Citations by year
- 2026: 11 · 2025: 12 · 2024: 14 · 2023: 12 · 2022: 7 · 2021: 15 · 2020: 19 · 2019: 2
- FWCI
- 8.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neuropsychopharmacology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- Klarman Family Foundation
- BrightFocus Foundation
- Ontario Brain Institute
- Fondation Brain Canada
- Campbell Institute
- Centre for Addiction and Mental Health
- Indivior
- Weston Brain Institute
- LivaNova
- Centre for Addiction and Mental Health Foundation
- BrainsWay
- MagVenture
- Ontario Ministry of Health and Long-Term Care
- H. Lundbeck A/S
- National Institutes of Health
- Canadian Institutes of Health Research
- Medical Research Council
- National Health and Medical Research Council (1078567)
- Ontario Ministry of Research and Innovation
- National Institute of Mental Health
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- magnetic seizure therapy, major depressive disorder, prefrontal cortex stimulation, high-frequency stimulation, cognitive impairment, memory, autobiographical memory recall, visuospatial memory, depression remission
- MeSH terms
- Mental Status and Dementia Tests, Adult, Depressive Disorder, Major, Major Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Middle Aged, Seizures, Magnetic Field Therapy
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