TY - JOUR

T1 - Low frequency rTMS, inhibits the antidepressive effect of ECT. A pilot study

AU - Buchholtz, Poul Erik

AU - Ashkanian, Mahmoud

AU - Hjerrild, Simon

AU - Hauptmann, Line Kirstine

AU - Devantier, Torben

AU - Jensen, Paulina

AU - Wissing, Sanne

AU - Thorgaard, Mette

AU - Speed, Maria

AU - Brund, Rene Børge Korsgaard

AU - Videbech, Poul

PY - 2020/7/27

Y1 - 2020/7/27

N2 - 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.

AB - 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.

KW - Health Sciences

KW - depression

KW - Electroconvulsive therapy (ECT)

KW - Keywords:

KW - Low frequency transcranial magnetic stimulation (rTMS)

KW - Randomized trial

UR - http://www.scopus.com/inward/record.url?scp=85091844919&partnerID=8YFLogxK

U2 - 10.1017/neu.2020.28

DO - 10.1017/neu.2020.28

M3 - Journal article

C2 - 32713367

VL - 32

SP - 328

EP - 338

JO - Acta Neuropsychiatrica (Online)

JF - Acta Neuropsychiatrica (Online)

SN - 1601-5215

IS - 6

ER -