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Low frequency rTMS, inhibits the antidepressive effect of ECT. A pilot study

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  • Poul Erik Buchholtz
  • Mahmoud Ashkanian
  • Simon Hjerrild
  • Line Kirstine Hauptmann
  • Torben Devantier
  • Paulina Jensen
  • Sanne Wissing
  • Mette Thorgaard
  • Maria Speed
  • Rene Børge Korsgaard Brund
  • Poul Videbech
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OBJECTIVE: Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex has been shown to have a statistically and clinically significant anti-depressant effect. The present pilot study was carried out to investigate if right prefrontal low-frequency rTMS as an add-on to electroconvulsive therapy (ECT) accelerates the anti-depressant effect and reduces cognitive side effects.

METHODS: In this randomised, controlled, double-blind study, thirty-five patients with major depression were allocated to ECT+placebo or ECT+low-frequency right prefrontal rTMS. The severity of depression was evaluated during the course using the Hamilton scale for depression (the 17-item as well as the 6-item scale) and the major depression inventory (MDI). Furthermore, neuropsychological assessment of cognitive function was carried out.

RESULTS: The study revealed no significant difference between the two groups for any of the outcomes, but with a visible trend to lower scores for MDI after treatment in the placebo group. The negative impact of ECT on neurocognitive functions was short-lived, and scores on logical memory were significantly improved compared to baseline 4 weeks after last treatment. The ECT-rTMS group revealed generally less impairment of cognitive functions than the ECT-placebo group.

CONCLUSION: The addition of low-frequency rTMS as an add-on to ECT treatment did not result in an accelerated response. On the contrary, the results suggest that low-frequency rTMS could inhibit the anti-depressant effect of ECT.

OriginalsprogEngelsk
TidsskriftActa Neuropsychiatrica
Vol/bind32
Udgave nummer6
Sider (fra-til)328-338
Antal sider11
ISSN1601-5215
DOI
StatusUdgivet - 27 jul. 2020

ID: 60687731