A controlled trial of daily left prefrontal cortex TMS for treating depression

Background: Transcranial magnetic stimulation (TMS) is a new technology for noninvasively stimulating the brain, Several studies have suggested that d aily stimulation of the left prefrontal cortex with TMS for 2 weeks has pro bable antidepressant effects. We conducted a parallel-design, double-masked , sham-controlled study to address whether 2 weeks of daily TMS over the le ft prefrontal cortex has antidepressant activity greater than sham. Methods: Thirty medication-free adult outpatients with nonpsychotic, major depressive (n = 21) or bipolar (n = 9) (depressed phase) disorder who were in a current major depression (Hamilton Rating Scale for Depression [HRSD] 21-item score of >18) were treated each weekday for 2 weeks. Subjects were randomly assigned to receive either daily active (20 subjects) or sham (10 subjects) stimulation. Additionally, the 20 active subjects I were equally divided between slower (5 Hz) andfaster (20 Hz) frequency treatment. Antide pressant response was defined as greater than a 50% improvement in the base line HRSD, Results: Active TMS resulted in significantly more responders (9/20) than d id sham (0/10) (chi (2) = 6.42, p < .01), The number of responders did not differ significantly between the two active cells (3/10 faster and 6/10 slo wer). Expressed as a percent change from baseline, active TMS subjects had significantly greater improvement on the Beck Depression Inventory as well as the Hamilton Anxiety Rating Scale than did those who received sham. Conclusions: Daily left prefrontal TMS for 2 weeks significantly reduced de pression symptoms greater than did sham, The two forms of active TMS treatm ent did not differ significantly, (C) 2000 Society of Biological Psychiatry .