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Three Weeks of rTMS Treatment Maintains Clinical Improvement But Not Electrophysiological Changes in Patients With Depression: A 6-Week Follow-Up Pilot Study

Our previous study demonstrated that 3 weeks of repetitive transcranial magnetic stimulation (rTMS) increases P200 amplitudes and improves the symptoms of depression and anxiety in depression patients. In the present study, we investigated whether 3 weeks of rTMS treatment maintained the P200 amplit...

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Autores principales: Choi, Kyung Mook, Choi, Soo-Hee, Lee, Sang Min, Jang, Kuk-In, Chae, Jeong-Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566016/
https://www.ncbi.nlm.nih.gov/pubmed/31231248
http://dx.doi.org/10.3389/fpsyt.2019.00351
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author Choi, Kyung Mook
Choi, Soo-Hee
Lee, Sang Min
Jang, Kuk-In
Chae, Jeong-Ho
author_facet Choi, Kyung Mook
Choi, Soo-Hee
Lee, Sang Min
Jang, Kuk-In
Chae, Jeong-Ho
author_sort Choi, Kyung Mook
collection PubMed
description Our previous study demonstrated that 3 weeks of repetitive transcranial magnetic stimulation (rTMS) increases P200 amplitudes and improves the symptoms of depression and anxiety in depression patients. In the present study, we investigated whether 3 weeks of rTMS treatment maintained the P200 amplitude in patients with depression at 6 weeks of follow-up. We measured the 6-week maintenance effects of rTMS using clinical questionnaires and an auditory oddball paradigm. Twenty-one patients with medication-resistant major depression participated in this pilot study. All patients underwent rTMS treatment for 3 weeks; they completed clinical ratings and performed the auditory oddball task at the pre-treatment, post-treatment, and 6-week follow-up visit (3 weeks after finishing rTMS treatment). The results revealed an increase in P200 amplitudes as well as improvements in the symptoms of depression and anxiety by 3 weeks of rTMS treatment. Furthermore, the results demonstrated maintenance effects on clinical ratings at 6-week follow-up. Depression and anxiety scales showed improvements in post-treatment and maintenance effects at the 6-week follow-up. Although P200 amplitude showed a significant main effect for 3 time points (baseline, post-treatment, and 6-week follow-up visit), at 2 time point comparisons, P200 amplitudes significantly increased in post-treatment compared to those of the baseline condition but did not show the maintenance effects of long-term rTMS at the 6-week follow-up compared to those of the baseline condition (  p = .173, Bonferroni correction). Standardized low-resolution brain electromagnetic tomography (sLORETA) for P200 showed significant activation in the left middle frontal gyrus in post-treatment but no significant activation at the 6-week follow-up. Moreover, the amplitudes of overall topographic distribution were reduced at 6 weeks of follow-up. The 3 weeks of rTMS treatment induced the maintenance of the improvements in the symptoms of depression and anxiety. However, considering the results of the event-related potential (ERP) and sLORETA, 3 weeks of rTMS treatment may not be sufficient to maintain this improvement, implying that a treatment period of more than 3 weeks may be required to reveal the electrophysiological maintenance effect of rTMS.
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spelling pubmed-65660162019-06-21 Three Weeks of rTMS Treatment Maintains Clinical Improvement But Not Electrophysiological Changes in Patients With Depression: A 6-Week Follow-Up Pilot Study Choi, Kyung Mook Choi, Soo-Hee Lee, Sang Min Jang, Kuk-In Chae, Jeong-Ho Front Psychiatry Psychiatry Our previous study demonstrated that 3 weeks of repetitive transcranial magnetic stimulation (rTMS) increases P200 amplitudes and improves the symptoms of depression and anxiety in depression patients. In the present study, we investigated whether 3 weeks of rTMS treatment maintained the P200 amplitude in patients with depression at 6 weeks of follow-up. We measured the 6-week maintenance effects of rTMS using clinical questionnaires and an auditory oddball paradigm. Twenty-one patients with medication-resistant major depression participated in this pilot study. All patients underwent rTMS treatment for 3 weeks; they completed clinical ratings and performed the auditory oddball task at the pre-treatment, post-treatment, and 6-week follow-up visit (3 weeks after finishing rTMS treatment). The results revealed an increase in P200 amplitudes as well as improvements in the symptoms of depression and anxiety by 3 weeks of rTMS treatment. Furthermore, the results demonstrated maintenance effects on clinical ratings at 6-week follow-up. Depression and anxiety scales showed improvements in post-treatment and maintenance effects at the 6-week follow-up. Although P200 amplitude showed a significant main effect for 3 time points (baseline, post-treatment, and 6-week follow-up visit), at 2 time point comparisons, P200 amplitudes significantly increased in post-treatment compared to those of the baseline condition but did not show the maintenance effects of long-term rTMS at the 6-week follow-up compared to those of the baseline condition (  p = .173, Bonferroni correction). Standardized low-resolution brain electromagnetic tomography (sLORETA) for P200 showed significant activation in the left middle frontal gyrus in post-treatment but no significant activation at the 6-week follow-up. Moreover, the amplitudes of overall topographic distribution were reduced at 6 weeks of follow-up. The 3 weeks of rTMS treatment induced the maintenance of the improvements in the symptoms of depression and anxiety. However, considering the results of the event-related potential (ERP) and sLORETA, 3 weeks of rTMS treatment may not be sufficient to maintain this improvement, implying that a treatment period of more than 3 weeks may be required to reveal the electrophysiological maintenance effect of rTMS. Frontiers Media S.A. 2019-06-07 /pmc/articles/PMC6566016/ /pubmed/31231248 http://dx.doi.org/10.3389/fpsyt.2019.00351 Text en Copyright © 2019 Choi, Choi, Lee, Jang and Chae http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Choi, Kyung Mook
Choi, Soo-Hee
Lee, Sang Min
Jang, Kuk-In
Chae, Jeong-Ho
Three Weeks of rTMS Treatment Maintains Clinical Improvement But Not Electrophysiological Changes in Patients With Depression: A 6-Week Follow-Up Pilot Study
title Three Weeks of rTMS Treatment Maintains Clinical Improvement But Not Electrophysiological Changes in Patients With Depression: A 6-Week Follow-Up Pilot Study
title_full Three Weeks of rTMS Treatment Maintains Clinical Improvement But Not Electrophysiological Changes in Patients With Depression: A 6-Week Follow-Up Pilot Study
title_fullStr Three Weeks of rTMS Treatment Maintains Clinical Improvement But Not Electrophysiological Changes in Patients With Depression: A 6-Week Follow-Up Pilot Study
title_full_unstemmed Three Weeks of rTMS Treatment Maintains Clinical Improvement But Not Electrophysiological Changes in Patients With Depression: A 6-Week Follow-Up Pilot Study
title_short Three Weeks of rTMS Treatment Maintains Clinical Improvement But Not Electrophysiological Changes in Patients With Depression: A 6-Week Follow-Up Pilot Study
title_sort three weeks of rtms treatment maintains clinical improvement but not electrophysiological changes in patients with depression: a 6-week follow-up pilot study
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566016/
https://www.ncbi.nlm.nih.gov/pubmed/31231248
http://dx.doi.org/10.3389/fpsyt.2019.00351
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