rTMS for adolescents: Safety and efficacy considerations

Department of Psychiatry and Behavioral Sciences, The School of Medicine, Johns Hopkins University, 600 N. Wolfe St. Baltimore, MD 21287, USA.
Psychiatry Research (Impact Factor: 2.47). 04/2010; 177(3):280-5. DOI: 10.1016/j.psychres.2010.03.004
Source: PubMed

ABSTRACT In light of both the FDA's clearance of repetitive transcranial magnetic stimulation (rTMS) for adult major depressive disorder and concerns about safety and efficacy of existing antidepressant therapies for adolescent depression, there is increasing interest in rTMS as a novel treatment for adolescent depression. We reviewed English-language studies using rTMS in persons under the age of 18, yielding 6 published reports. Because rTMS is typically delivered at or above 1 Hz for psychiatric indications, our search was confined to these frequencies. Also included are studies involving rTMS above 1 Hz for non-psychiatric indications. Articles were retrieved from the MEDLINE database. There were 19 reported subjects under age 18 who have been administered rTMS at a frequency above 1 Hz: 10 for major depression, 5 for spastic cerebral palsy and 4 for epilepsia partialis continua. We found that most subjects responded favorably to rTMS and no adverse events have been reported. However data are insufficient for drawing firm conclusions about safety and efficacy. Further studies of rTMS as a treatment for adolescent depression are warranted.

12 Reads
  • Source
    • "For these adult populations the most common side effects of treatment are transient scalp discomfort and headaches [20]. Concerns have also been raised regarding the likelihood of seizures induced by treatment [20] [21]. Safety reviews estimate a one in 30,000 chance of seizure due to rTMS procedures [16] [20]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Depressive disorders are among the most commonly experienced mental health concerns and a leading cause of mortality in adolescence. Current treatment guidelines recommend the use of antidepressant medication, cognitive behavioral therapy or both treatments. Unfortunately 40–60% of adolescents fail to respond to these treatments, therefore a new effective alternative treatment modality would be of particular benefit. rTMS is effective in addressing treatment resistant depression in adults and investigation into its effectiveness with adolescent populations has begun. Objective To examine the existing literature regarding the efficacy and safety of rTMS treatment with adolescents experiencing depressive symptoms, especially research conducted since the last published review. Methods A systematic review was conducted in accordance with PRISMA guidelines. The databases of OVID PsycINFO, PubMed, Ovid Medline and Web of Science were searched for research utilizing rTMS treatment with adolescents experiencing depressive symptomology. Results The review identified seven studies that examined rTMS as a treatment for depressive symptomology in adolescence. Findings indicate rTMS is likely to be an effective treatment for young people with preliminary longitudinal results suggesting maintenance of effects 3 years post-treatment. Reported side effects have included headaches, scalp discomfort and single incidences of hypomania and seizure. All side effects were transitory and did not recur. Conclusion Preliminary results suggest rTMS is an effective and well tolerated antidepressant treatment for adolescents with treatment resistant depressive symptomology. Further research allowing for comparison across studies is necessary to establish the efficacy of rTMS in adolescent depression.
    Brain Stimulation 02/2014; 7(1):7–12. DOI:10.1016/j.brs.2013.09.012 · 4.40 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We present the design of a radio modem for the MOBITEX wireless data system. The MOBITEX interface specification defines the protocols that are used for communication between the MOBITEX network and mobile terminal devices. The specification refers to the ISO/OSI standards and defines the link layer and the physical layer of the air-link radio protocol for mobile terminals, as well as the network layer protocol that describes how packets are transmitted between the sender and the addressee. Because the design of a MOBITEX radio modem should serve as an application case study for identifying the needs in a joint air-link and network protocol design, we use different existing design methods and software tools for the specification of the lower three layers. For analyses and design we use Rumbaugh's object modeling technique (OMT). For implementation and validation we apply the standardized specification and description language SDL and data-flow oriented system specifications
    Acoustics, Speech, and Signal Processing, 1996. ICASSP-96. Conference Proceedings., 1996 IEEE International Conference on; 06/1996
  • [Show abstract] [Hide abstract]
    ABSTRACT: Summary form only given. As background, we describe frequently used feed forward wide-area power system stability controls. Then we describe online demonstration of a new response-based (feedback) wide-area stability and voltage control system (WACS). The control system uses powerful discontinuous actions for power system stabilization. The control system comprises phasor measurements at many substations, fiber optic communications, real-time deterministic computers, and transfer trip output signals to circuit breakers at many other substations and power plants. Finally, we describe future development of WACS. WACS is developed as a flexible platform to prevent blackouts and facilitate electrical commerce.
    Power Systems Conference and Exposition, 2004. IEEE PES; 11/2004
Show more