An open study of repetitive transcranial magnetic stimulation in treatment-resistant depression with Parkinson's disease

Emory University, Atlanta, Georgia, United States
Clinical Neurophysiology (Impact Factor: 3.1). 11/2007; 118(10):2189-94. DOI: 10.1016/j.clinph.2007.07.010
Source: PubMed


Major depression is a common concomitant of chronic central nervous system disorders, notably Parkinson's disease (PD). Repetitive transcranial magnetic stimulation (rTMS) has been investigated as a potential treatment for depression in PD and for the movement disorder of PD, but comprehensive testing in multiple areas of performance has seldom been carried out within a single study. We studied the effect of left dorsolateral prefrontal rTMS on several different functional domains.
Fourteen PD patients with treatment-resistant depression entered an open, 10-day inpatient study of 10-Hz rTMS, undergoing extensive psychiatric, neuropsychological, and motor testing from baseline to 6 weeks after treatment. Motor testing included a defined "off" state.
rTMS was well tolerated. Highly significant improvement in depression scores was seen 3 days and 3-6 weeks after treatment. Improvement was also found in anxiety, movement scores (especially in the off state), and some neuropsychological measures. We found no evidence of increased risk from rTMS in this population.
Further controlled trials of rTMS in PD appear worthwhile, and should include a defined "off" state.
TMS may be beneficial for depressed PD patients in multiple functional domains.

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    ABSTRACT: Repetitive transcranial magnetic stimulation (rTMS) represents a promising tool for studying and influencing cognition in people with neurodegenerative diseases. This procedure is noninvasive and painless, and it does not require the use of anesthesia or pharmacological substances. In this systematic critical review we report outcomes from research focused on behavioral cognitive effects induced by rTMS in patients with Alzheimer's disease (AD), Parkinson's disease (PD), and mild cognitive impairment (MCI) preceding AD. There are still major limitations to rTMS use, such as a poor understanding of its after-effects and inter-individual variability in their magnitude, discrepancies in stimulation protocols and study designs, varied selection of the specific stimulated areas and control procedures, and neuropsychological methods for assessment of after-effects; hence, the results of the present research can only be considered preliminary. The future directions are discussed.
    Full-text · Article · Feb 2014 · Journal of the neurological sciences
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    • "We found five studies using rTMS for the treatment of depression in PD. Two were randomized clinical trials (RCTs) and three were open trials (64-66). Fregni et al. (67) evaluated 42 patients using high-frequency rTMS over the DLPFC. "
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    • "The transient magnetic field then causes an electrical current in neurons or axons in the brain (Ni and Chen, 2009). At the moment, TMS has been widely used in neurophysiological studies, and its effect is being investigated in the treatment of neurological and psychiatric diseases, including Parkinson's disease, schizophrenia, and depression (Sachdev et al., 2002; Epstein et al., 2007; Zaman et al., 2008; González-García et al., 2011). "
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