Repetitive Transcranial Magnetic Stimulation in Youth With Treatment Resistant Major Depression
Background: Major depressive disorder (MDD) is common in youth and treatment options are limited. We evaluated the effectiveness and safety of repetitive transcranial magnetic stimulation (rTMS) in adolescents and transitional aged youth with treatment resistant MDD.Methods: Thirty-two outpatients w...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-03-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fpsyt.2019.00170/full |
| _version_ | 1818684043354439680 |
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| author | Frank P. MacMaster Frank P. MacMaster Paul E. Croarkin T. Christopher Wilkes Quinn McLellan Lisa Marie Langevin Natalia Jaworska Rose M. Swansburg Yamile Jasaui Ephrem Zewdie Patrick Ciechanski Adam Kirton |
| author_facet | Frank P. MacMaster Frank P. MacMaster Paul E. Croarkin T. Christopher Wilkes Quinn McLellan Lisa Marie Langevin Natalia Jaworska Rose M. Swansburg Yamile Jasaui Ephrem Zewdie Patrick Ciechanski Adam Kirton |
| author_sort | Frank P. MacMaster |
| collection | DOAJ |
| description | Background: Major depressive disorder (MDD) is common in youth and treatment options are limited. We evaluated the effectiveness and safety of repetitive transcranial magnetic stimulation (rTMS) in adolescents and transitional aged youth with treatment resistant MDD.Methods: Thirty-two outpatients with moderate to severe, treatment-resistant MDD, aged 13–21 years underwent a three-week, open-label, single center trial of rTMS (ClinicalTrials.gov identifier NCT01731678). rTMS was applied to the left dorsolateral prefrontal cortex (DLPFC) using neuronavigation and administered for 15 consecutive week days (120% rest motor threshold; 40 pulses over 4 s [10 Hz]; inter-train interval, 26 s; 75 trains; 3,000 pulses). The primary outcome measure was change in the Hamilton Depression Rating Scale (Ham-D). Treatment response was defined as a >50% reduction in Ham-D scores. Safety and tolerability were also examined.Results: rTMS was effective in reducing MDD symptom severity (t = 8.94, df = 31, p < 0.00001). We observed 18 (56%) responders (≥ 50% reduction in Ham-D score) and 14 non-responders to rTMS. Fourteen subjects (44%) achieved remission (Ham-D score ≤ 7 post-rTMS). There were no serious adverse events (i.e., seizures). Mild to moderate, self-limiting headaches (19%) and mild neck pain (16%) were reported. Participants ranked rTMS as highly tolerable. The retention rate was 91% and compliance rate (completing all study events) was 99%.Conclusions: Our single center, open trial suggests that rTMS is a safe and effective treatment for youth with treatment resistant MDD. Larger randomized controlled trials are needed.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT01731678 |
| first_indexed | 2024-12-17T10:44:21Z |
| format | Article |
| id | doaj.art-a2598db5bda5451792fab0db952ec729 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-17T10:44:21Z |
| publishDate | 2019-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-a2598db5bda5451792fab0db952ec7292022-12-21T21:52:09ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402019-03-011010.3389/fpsyt.2019.00170450432Repetitive Transcranial Magnetic Stimulation in Youth With Treatment Resistant Major DepressionFrank P. MacMaster0Frank P. MacMaster1Paul E. Croarkin2T. Christopher Wilkes3Quinn McLellan4Lisa Marie Langevin5Natalia Jaworska6Rose M. Swansburg7Yamile Jasaui8Ephrem Zewdie9Patrick Ciechanski10Adam Kirton11Departments of Pediatrics and Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, CanadaStrategic Clinical Network for Addictions and Mental Health, Alberta Health Services, Calgary, AB, CanadaDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, NY, United StatesDepartments of Pediatrics and Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, CanadaDepartments of Pediatrics and Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, CanadaDepartments of Pediatrics and Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, CanadaInstitute of Mental Health Research, University of Ottawa, Ottawa, ON, CanadaDepartments of Pediatrics and Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, CanadaDepartments of Pediatrics and Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, CanadaDepartments of Pediatrics and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, CanadaDepartments of Pediatrics and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, CanadaDepartments of Pediatrics and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, CanadaBackground: Major depressive disorder (MDD) is common in youth and treatment options are limited. We evaluated the effectiveness and safety of repetitive transcranial magnetic stimulation (rTMS) in adolescents and transitional aged youth with treatment resistant MDD.Methods: Thirty-two outpatients with moderate to severe, treatment-resistant MDD, aged 13–21 years underwent a three-week, open-label, single center trial of rTMS (ClinicalTrials.gov identifier NCT01731678). rTMS was applied to the left dorsolateral prefrontal cortex (DLPFC) using neuronavigation and administered for 15 consecutive week days (120% rest motor threshold; 40 pulses over 4 s [10 Hz]; inter-train interval, 26 s; 75 trains; 3,000 pulses). The primary outcome measure was change in the Hamilton Depression Rating Scale (Ham-D). Treatment response was defined as a >50% reduction in Ham-D scores. Safety and tolerability were also examined.Results: rTMS was effective in reducing MDD symptom severity (t = 8.94, df = 31, p < 0.00001). We observed 18 (56%) responders (≥ 50% reduction in Ham-D score) and 14 non-responders to rTMS. Fourteen subjects (44%) achieved remission (Ham-D score ≤ 7 post-rTMS). There were no serious adverse events (i.e., seizures). Mild to moderate, self-limiting headaches (19%) and mild neck pain (16%) were reported. Participants ranked rTMS as highly tolerable. The retention rate was 91% and compliance rate (completing all study events) was 99%.Conclusions: Our single center, open trial suggests that rTMS is a safe and effective treatment for youth with treatment resistant MDD. Larger randomized controlled trials are needed.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT01731678https://www.frontiersin.org/article/10.3389/fpsyt.2019.00170/fulladolescentdepressiontranscrancial magnetic stimulation (TMS)dorsolateral prefrontal cortex (DLPFC)brain stimulation |
| spellingShingle | Frank P. MacMaster Frank P. MacMaster Paul E. Croarkin T. Christopher Wilkes Quinn McLellan Lisa Marie Langevin Natalia Jaworska Rose M. Swansburg Yamile Jasaui Ephrem Zewdie Patrick Ciechanski Adam Kirton Repetitive Transcranial Magnetic Stimulation in Youth With Treatment Resistant Major Depression Frontiers in Psychiatry adolescent depression transcrancial magnetic stimulation (TMS) dorsolateral prefrontal cortex (DLPFC) brain stimulation |
| title | Repetitive Transcranial Magnetic Stimulation in Youth With Treatment Resistant Major Depression |
| title_full | Repetitive Transcranial Magnetic Stimulation in Youth With Treatment Resistant Major Depression |
| title_fullStr | Repetitive Transcranial Magnetic Stimulation in Youth With Treatment Resistant Major Depression |
| title_full_unstemmed | Repetitive Transcranial Magnetic Stimulation in Youth With Treatment Resistant Major Depression |
| title_short | Repetitive Transcranial Magnetic Stimulation in Youth With Treatment Resistant Major Depression |
| title_sort | repetitive transcranial magnetic stimulation in youth with treatment resistant major depression |
| topic | adolescent depression transcrancial magnetic stimulation (TMS) dorsolateral prefrontal cortex (DLPFC) brain stimulation |
| url | https://www.frontiersin.org/article/10.3389/fpsyt.2019.00170/full |
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