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CNS & Neurological Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5273
ISSN (Online): 1996-3181

Research Article

High-frequency Repetitive Transcranial Magnetic Stimulation (rTMS) Accelerates onset Time of Beneficial Treating Effects and Improves Clinical Symptoms of Depression

Author(s): Lilei Dai, Peng Wang, Hui Du, Qingshan Guo, Fen Li, Xinfu He and Shaohong Zou*

Volume 21, Issue 6, 2022

Published on: 01 December, 2021

Page: [500 - 510] Pages: 11

DOI: 10.2174/1871527320666211104123343

Price: $65

Abstract

Background: In recent years, more and more patients with depression demonstrate suicidal intention and suicidal behavior.

Objective: To evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in treating depression with suicidal ideation.

Methods: Eighty-nine depression patients with suicide intention were administrated drugs combined with four weeks of Active rTMS (n=40) or sham (n=49) rTMS treatment. The 24-item Hamilton Depression Rating Scale for Depression (HAMD-24) and Self-rating Idea of Suicide Scale (SIOSS) were used to evaluate suicide risk and depression severity at baseline, weeks 2 and 4. A 25% reduction in HAMD-24 score from baseline was defined as treatment response. More than a 20% reduction in HAMD-24 score from baseline within the first 2 weeks of treatment was defined as an early improvement.

Results: No statistical significance was found for baseline sociodemographic and illness characteristics between the two groups (P >0.05). There was a significant difference for HAMD-24 and SIOSS scores between the two groups at weeks 2 and 4. Active rTMS group demonstrated a more significant score reduction compared to the Sham rTMS group at weeks 2 and 4. There was a significantly greater number of patients with early improvement observed in the Active rTMS group compared to those in the Sham rTMS group at weeks 2 (P <0.05). There was a significant difference in responder rates between the two groups at weeks 4 for HAMD-24 scores (P <0.05).

Conclusion: rTMS could accelerate the onset time of beneficial treating effects and improve clinical symptoms of depression. During the treatment course, cognitive disorder, sleep disorder, anxiety/ somatization, retardation, and hopelessness symptoms were improved dramatically, and suicidal ideation was reduced.

Keywords: Repetitive transcranial magnetic stimulation, depression, suicide, cognition, Active rTMS, mental disorder.

Graphical Abstract

[1]
Yang JY, Yao J, Huang YQ, et al. Mental disorders affected on suicidal behaviours. Chin J Health Psychol 2019; 17: 522-4.
[2]
Safa A, Omrani MD, Nicknafs F, Oskooei VK, Taheri M, Ghafouri-Fard S. Assessment of association between NINJ2 polymorphisms and suicide attempts in Iranian population. J Mol Neurosci 2020; 70(11): 1880-6.
[http://dx.doi.org/10.1007/s12031-020-01584-x] [PMID: 32436199]
[3]
WHO Preventing Suicide: A Global Imperative Geneva, Switzerland: WHO. 2014.
[4]
Hawton K, Casañas I Comabella C, Haw C, Saunders K, Saunders K. Risk factors for suicide in individuals with depression: a systematic review. J Affect Disord 2013; 147(1-3): 17-28.
[http://dx.doi.org/10.1016/j.jad.2013.01.004] [PMID: 23411024]
[5]
Quitkin FM, Rabkin JG, Ross D, McGrath PJ. Duration of antidepressant drug treatment. What is an adequate trial? Arch Gen Psychiatry 1984; 41(3): 238-45.
[http://dx.doi.org/10.1001/archpsyc.1984.01790140028003] [PMID: 6367689]
[6]
Quitkin FM, Rabkin JG, Ross D, Stewart JW. Identification of true drug response to antidepressants. Use of pattern analysis. Arch Gen Psychiatry 1984; 41(8): 782-6.
[http://dx.doi.org/10.1001/archpsyc.1984.01790190056007] [PMID: 6378117]
[7]
Wilkinson ST, Ballard ED, Bloch MH, et al. The Effect of a Single Dose of Intravenous Ketamine on Suicidal Ideation: A Systematic Review and Individual Participant Data Meta-Analysis. Am J Psychiatry 2018; 175(2): 150-8.
[http://dx.doi.org/10.1176/appi.ajp.2017.17040472] [PMID: 28969441]
[8]
Phillips JL, Norris S, Talbot J, et al. Single and repeated ketamine infusions for reduction of suicidal ideation in treatment-resistant depression. Neuropsychopharmacology 2020; 45(4): 606-12.
[http://dx.doi.org/10.1038/s41386-019-0570-x] [PMID: 31759333]
[9]
Henkel V, Seemüller F, Obermeier M, et al. Does early improvement triggered by antidepressants predict response/remission? Analysis of data from a naturalistic study on a large sample of inpatients with major depression. J Affect Disord 2009; 115(3): 439-49.
[http://dx.doi.org/10.1016/j.jad.2008.10.011] [PMID: 19027961]
[10]
Szegedi A, Jansen WT, van Willigenburg AP, van der Meulen E, Stassen HH, Thase ME. Early improvement in the first 2 weeks as a predictor of treatment outcome in patients with major depressive disorder: a meta-analysis including 6562 patients. J Clin Psychiatry 2009; 70(3): 344-53.
[http://dx.doi.org/10.4088/JCP.07m03780] [PMID: 19254516]
[11]
Leuchter AF, Cook IA, Jin Y, Phillips B. The relationship between brain oscillatory activity and therapeutic effectiveness of transcranial magnetic stimulation in the treatment of major depressive disorder. Front Hum Neurosci 2013; 7: 37.
[http://dx.doi.org/10.3389/fnhum.2013.00037] [PMID: 23550274]
[12]
Wang S, Mao S, Yao B, Xiang D, Fang C. Effects of low-frequency repetitive transcranial magnetic stimulation on depression- and anxiety-like behaviors in epileptic rats. J Integr Neurosci 2019; 18(3): 237-43.
[http://dx.doi.org/10.31083/j.jin.2019.03.1100] [PMID: 31601071]
[13]
Iglesias AH. Transcranial magnetic stimulation as treatment in multiple neurologic conditions. Curr Neurol Neurosci Rep 2020; 20(1): 1.
[http://dx.doi.org/10.1007/s11910-020-1021-0] [PMID: 32020300]
[14]
Kiebs M, Hurlemann R, Mutz J. Repetitive transcranial magnetic stimulation in non-treatment-resistant depression. Br J Psychiatry 2019; 215(2): 445-6.
[http://dx.doi.org/10.1192/bjp.2019.75] [PMID: 31014413]
[15]
Du J, Yang F, Hu J, et al. Effects of high- and low-frequency repetitive transcranial magnetic stimulation on motor recovery in early stroke patients: Evidence from a randomized controlled trial with clinical, neurophysiological and functional imaging assessments. Neuroimage Clin 2019; 21: 101620.
[http://dx.doi.org/10.1016/j.nicl.2018.101620] [PMID: 30527907]
[16]
Holtzheimer PE III, McDonald WM, Mufti M, et al. Accelerated repetitive transcranial magnetic stimulation for treatment-resistant depression. Depress Anxiety 2010; 27(10): 960-3.
[http://dx.doi.org/10.1002/da.20731] [PMID: 20734360]
[17]
Fitzgerald PB, Hoy KE, Elliot D, Susan McQueen RN, Wambeek LE, Daskalakis ZJ. Accelerated repetitive transcranial magnetic stimulation in the treatment of depression. Neuropsychopharmacology 2018; 43(7): 1565-72.
[http://dx.doi.org/10.1038/s41386-018-0009-9] [PMID: 29467437]
[18]
Kaur M, Michael JA, Fitzgibbon BM, Hoy KE, Fitzgerald PB. Low-frequency rTMS is better tolerated than high-frequency rTMS in healthy people: Empirical evidence from a single session study. J Psychiatr Res 2019; 113: 79-82.
[http://dx.doi.org/10.1016/j.jpsychires.2019.03.015] [PMID: 30913448]
[19]
Lingeswaran A. Repetitive Transcranial Magnetic Stimulation in the Treatment of depression: A Randomized, Double-blind, Placebo-controlled Trial. Indian J Psychol Med 2011; 33(1): 35-44.
[http://dx.doi.org/10.4103/0253-7176.85393] [PMID: 22021951]
[20]
Naoi M, Maruyama W, Shamoto-Nagai M. Type A monoamine oxidase and serotonin are coordinately involved in depressive disorders: from neurotransmitter imbalance to impaired neurogenesis. J Neural Transm (Vienna) 2018; 125(1): 53-66.
[http://dx.doi.org/10.1007/s00702-017-1709-8] [PMID: 28293733]
[21]
Jang D, Lee HJ, Lee K, et al. White Ginseng ameliorates depressive behavior and increases hippocampal 5-HT level in the stressed ovariectomized rats. BioMed Res Int 2019; 2019: 5705232.
[http://dx.doi.org/10.1155/2019/5705232] [PMID: 31612144]
[22]
Chou YH, Ton That V, Sundman M. A systematic review and meta-analysis of rTMS effects on cognitive enhancement in mild cognitive impairment and Alzheimer’s disease. Neurol Aging 2020; 86: 1-10.
[http://dx.doi.org/10.1016/j.neurobiolaging.2019.08.020] [PMID: 31783330]
[23]
George MS, Raman R, Benedek DM, et al. A two-site pilot randomized 3 day trial of high dose left prefrontal repetitive transcranial magnetic stimulation (rTMS) for suicidal inpatients. Brain Stimul 2014; 7(3): 421-31.
[http://dx.doi.org/10.1016/j.brs.2014.03.006] [PMID: 24731434]
[24]
Taylor R, Galvez V, Loo C. Transcranial magnetic stimulation (TMS) safety: a practical guide for psychiatrists. Australas Psychiatry 2018; 26(2): 189-92.
[http://dx.doi.org/10.1177/1039856217748249] [PMID: 29338288]
[25]
Ramberg M, Stanley B, Ystgaard M, Mehlum L. Depressed suicide attempters with posttraumatic stress disorder. Arch Suicide Res 2015; 19(1): 48-59.
[http://dx.doi.org/10.1080/13811118.2014.915777] [PMID: 25058681]
[26]
Roy B, Wang Q, Palkovits M, Faludi G, Dwivedi Y. Altered miRNA expression network in locus coeruleus of depressed suicide subjects. Sci Rep 2017; 7(1): 4387.
[http://dx.doi.org/10.1038/s41598-017-04300-9] [PMID: 28663595]
[27]
Qin BY, Dai LL, Zheng Y. [Efficacy of repetitive transcranial magnetic stimulation for alleviating clinical symptoms and suicidal ideation in elderly depressive patients: a randomized controlled trial]. Nan Fang Yi Ke Da Xue Xue Bao 2017; 37(1): 97-101.
[PMID: 28109107]
[28]
Dai JG, Chen L, Zhao YN, Huang YF, Wang XD. The animal experiment on the antidepressant effect of Yang Ning God. Shandong Yiyao 2010; 50: 46-7.
[29]
Rossini D, Magri L, Lucca A, Giordani S, Smeraldi E, Zanardi R. Does rTMS hasten the response to escitalopram, sertraline, or venlafaxine in patients with major depressive disorder? A double-blind, randomized, sham-controlled trial. J Clin Psychiatry 2005; 66(12): 1569-75.
[http://dx.doi.org/10.4088/JCP.v66n1212] [PMID: 16401159]
[30]
Cheng S, Jia C, Wang Y. Only children were associated with anxiety and depressive symptoms among college student’s in China. Int J Environ Res Public Health 2020; 17: 4035.
[http://dx.doi.org/10.3390/ijerph17114035]
[31]
Shen Y, Yao J, Jiang X, et al. Sub-hubs of baseline functional brain networks are related to early improvement following two-week pharmacological therapy for major depressive disorder. Hum Brain Mapp 2015; 36(8): 2915-27.
[http://dx.doi.org/10.1002/hbm.22817] [PMID: 25930660]
[32]
Dai L, Wang P, Zhang P, et al. The therapeutic effect of repetitive transcranial magnetic stimulation in elderly depression patients. Medicine (Baltimore) 2020; 99(32): e21493.
[http://dx.doi.org/10.1097/MD.0000000000021493] [PMID: 32769884]
[33]
Park MJ, Kim H, Kim EJ, et al. Recent updates on electro-convulsive therapy in patients with depression. Psychiatry Investig 2021; 18(1): 1-10.
[http://dx.doi.org/10.30773/pi.2020.0350] [PMID: 33321557]
[34]
Huang ML, Luo BY, Hu JB, et al. Repetitive transcranial magnetic stimulation in combination with citalopram in young patients with first-episode major depressive disorder: a double-blind, randomized, sham-controlled trial. Aust N Z J Psychiatry 2012; 46(3): 257-64.
[http://dx.doi.org/10.1177/0004867411433216] [PMID: 22391283]
[35]
Yoshimura R. [Treatment of depression from the point of view of suicide prevention]. Seishin Shinkeigaku Zasshi 2007; 109(9): 822-33.
[PMID: 18064872]
[36]
Desmyter S, Duprat R, Baeken C, Bijttebier S, van Heeringen K. The acute effects of accelerated repetitive Transcranial Magnetic Stimulation on suicide risk in unipolar depression: preliminary results. Psychiatr Danub 2014; 26(Suppl. 1): 48-52.
[PMID: 25413512]
[37]
Wang X, Cheng S, Xu H. Systematic review and meta-analysis of the relationship between sleep disorders and suicidal behaviour in patients with depression. BMC Psychiatry 2019; 19(1): 303.
[http://dx.doi.org/10.1186/s12888-019-2302-5] [PMID: 31623600]
[38]
Du ZD, Liu Y, Wang LL, Zhag DY. The observation of transcranial magnetic stimulation in the treatment of depression sleep disturbances. Shandong Yiyao 2011; 51: 48-9.
[39]
Pellicciari MC, Cordone S, Marzano C, et al. Dorsolateral prefrontal transcranial magnetic stimulation in patients with major depression locally affects alpha power of REM sleep. Front Hum Neurosci 2013; 7: 433.
[http://dx.doi.org/10.3389/fnhum.2013.00433] [PMID: 23935577]
[40]
Wang YX, Sun ML, Long JL. Clinical analysis on the risk factors of suicidal behaviours in patients with depression. Chin J Health Psychology 2005; 13: 90-1.
[41]
Liu X, Shen YL, Liang ZQ, Ren Y, Zhang KR. Relationship between depressive state and suicidal ideation of patients with depression. Chin J of Health Psychol 2013; 21: 806-7.
[42]
Wang P, Zhao Z, Yang SC. The clinical observation of repetitive transcranial magnetic stimulation combined with mirtazapine in treatment of first-episode depression. Chin Mod Med 2014; 21: 42-4.
[43]
Yin H, Pantazatos SP, Galfalvy H, et al. A pilot integrative genomics study of GABA and glutamate neurotransmitter systems in suicide, suicidal behavior, and major depressive disorder. Am J Med Genet B Neuropsychiatr Genet 2016; 171B(3): 414-26.
[http://dx.doi.org/10.1002/ajmg.b.32423] [PMID: 26892569]
[44]
Limon A, Mamdani F, Hjelm BE, Vawter MP, Sequeira A. Targets of polyamine dysregulation in major depression and suicide: Activity-dependent feedback, excitability, and neurotransmission. Neurosci Biobehav Rev 2016; 66: 80-91.
[http://dx.doi.org/10.1016/j.neubiorev.2016.04.010] [PMID: 27108532]
[45]
Berlim MT, Van den Eynde F, Daskalakis ZJ. High-frequency repetitive transcranial magnetic stimulation accelerates and enhances the clinical response to antidepressants in major depression: a meta-analysis of randomized, double-blind, and sham-controlled trials. J Clin Psychiatry 2013; 74(2): e122-9.
[http://dx.doi.org/10.4088/JCP.12r07996] [PMID: 23473357]
[46]
Baeken C. Accelerated rTMS: A Potential Treatment to Alleviate Refractory Depression. Front Psychol 2018; 9: 2017.
[http://dx.doi.org/10.3389/fpsyg.2018.02017] [PMID: 30429807]

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