Long Term Efficacy of Brain SPECT Assisted Repetitive Transcranial Magnetic Stimulation (RTMS) in Treatment Resistant Major Depressive Disorder-One Year Follow-Up Study

SOURCE: Indian Journal of Psychiatry. Conference: 69th Annual Conference of Indian Psychiatric Society, ANCIPS 2017. Raipur India. 59(Supplement 2) (pp S188-S189), 2017.


AUTHORS: Jha S.; Chadda R.; Kumar N.; Ba C.S.

BACKGROUND: Several studies have assessed the acute antidepressant effects of repetitive transcranial magnetic stimulation (RTMS), and many have revealed positive results. The efficacy of rTMS has been poorly investigated in the long-term. The present follow-up study was aimed to assess the long-term efficacy of brain single-photon emission computed tomography (SPECT) assisted rTMS on treatment in patients with treatment resistant major depressive disorder (MDD).

METHOD(S): After the completion of acute trial with twenty sessions of rTMS administered to 20 patients with treatment resistant MDD, the patients in each group i and ii (based on brain SPECT findings) entered a naturalistic follow-up for one year. The patients were evaluated two times with the standardized instruments i.e. After six months and one year. The subjects were continued on their antidepressant medications as usual.

RESULT(S): Patients in the group I showed a better response as compared to those in group ii, as shown by higher reduction in scores on MADRS, BDI and CGI. No long term complication were noticed.

LIMITATION(S): Small sample size, drop outs and non-controlled design. All patients were receiving the standard antidepressant therapy.

CONCLUSION(S): This prospective study found that administration of RTMS with enhanced protocol including specified site of stimulation has better clinical outcome and long term efficacy compared to the standard protocol. The immediate remission is predictive of sustained benefit after 1 year. Larger controlled studies are needed to confirm present preliminary findings.

LINK TO FULL ARTICLE: https://journals.lww.com/indianjpsychiatry/toc/2017/59002