A functional magnetic resonance imaging study of the effects of low frequency right prefrontal transcranial magnetic stimulation in depression

• Published in: Journal of clinical psychopharmacology Vol. 27; no. 5; p. 488
• Main Authors: Fitzgerald, Paul B, Sritharan, Anusha, Daskalakis, Zafiris J, de Castella, Anthony R, Kulkarni, Jayashri, Egan, Gary
• Format: Journal Article
• Language: English
• Published: United States 01.10.2007
• Subjects: Adult; Brain Mapping; Depressive Disorder, Major - therapy; Double-Blind Method; Female; Frontal Lobe - metabolism; Frontal Lobe - physiology; Functional Laterality - physiology; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Oxygen - blood; Prefrontal Cortex - metabolism; Prefrontal Cortex - physiology; Psychiatric Status Rating Scales; Psychometrics; Transcranial Magnetic Stimulation - methods
• ISSN: 0271-0749
• DOI: 10.1097/jcp.0b013e318151521c

The study aimed to explore the biological effects of low-frequency repetitive transcranial magnetic stimulation (LFR-TMS) treatment applied to the right prefrontal cortex, comparing this with the effects of high-frequency left-sided (HFL-TMS) in patients with treatment-resistant depression. Twenty-six patients with treatment-resistant depression were randomized to receive either daily LFR-TMS or HFL-TMS treatment for 3 weeks and underwent functional magnetic resonance imaging during a planning task before and after treatment. Patients responded clinically to both forms of treatment with no difference in the degree of response (F1,24 = 0.65;P > 0.05). Low-frequency repetitive transcranial magnetic stimulation resulted in no overall change in task-related activation. However, responders to LFR-TMS demonstrated a bilateral decrease in activity in middle frontal gyrus. In contrast, HFL-TMS produced an increase in activation in left precuneus with responders showing increased activation in several additional regions. Response to LFR-TMS is associated with a bilateral reduction in frontal activation that does not seem to be a nonspecific effect of treatment and differs from the response to HFL-TMS.