Acute mood and thyroid stimulating hormone effects of transcranial magnetic stimulation in major depression

Background: Repetitive transcranial magnetic stimulation (rTMS) has recentl y been demonstrated to have antidepressant effects. Some wonk suggests that rTMS over prefrontal cortex administered to healthy individuals produces a cute elevations of mood and serum thyroid-stimulating hormone (TSH). We sou ght to determine whether single rTMS sessions would produce acute mood and serum TSH elevations in subjects with major depressions. Methods: Under double-blind conditions et al 14 medication-free subjects wi th major depression received individual sessions of either active or sham r TMS. rTMS was administered over the left prefrontal cortex at 10 Hz et al 1 00% of motor threshold 20 trains over 10 min. Immediately before and after rTMS sessions, subjects' mood was rated with the Profile of Mood States (PO MS) and the 6-Item Hamilton Depression Scale, and blood was drawn for later analysis of TSH. Subjects and raters were blind to treatment assignment. Results: The group receiving active stimulation manifested significantly gr eater improvement on the POMS subscale of Depression (p less than or equal to .0055) and a trend toward greater improvement on the modified Hamilton R ating (.05 < p <less than or equal to> .1). No hypomania was induced. The c hange in TSH from pre- to post-rTMS was significantly different between act ive and sham sessions. Conclusions: This blinded, placebo-controlled trial documents that individu al rTMS sessions can acutely elevate mood and stimulate TSH release in pati ents experiencing major depressive episodes. Biol Psychiatry 2001;50, 22-27 (C) 2001 Society of Biological Psychiatry.