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Int J Psychiatry Clin Pract. 2015;19(4):252-8. doi: 10.3109/13651501.2015.1084329. Epub 2015 Sep 23.

Repetitive transcranial magnetic stimulation in patients with drug-resistant major depression: A six-month clinical follow-up study.

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a Department of Clinical and Experimental Medicine , Psychiatry Unit, University of Catania , Via Santa Sofia, Catania , Italy.
b Department of Neurology I.C. , "Oasi" Institute for Research on Mental Retardation and Brain Aging (I.R.C.C.S.) . Via Conte Ruggero, Troina (EN) , Italy.
c Department "Specialità Medico-Chirurgiche" , University of Catania , Via Santa Sofia, Catania , Italy.
d Department of Medical and Surgical Sciences and Advanced Technologies , Section of Neurosciences , Via Santa Sofia, Catania , Italy.



In this study we aimed to assess the long-term efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) on depressive symptoms and cognitive performance in patients with drug-resistant major depressive disorder (MDD).


Fifteen drug-resistant depressed outpatients completed an acute trial with augmentative high-frequency rTMS over the left dorsolateral prefrontal cortex (DLPFC) and were compared with 15 drug-resistant MDD patients who underwent sham procedure. Depressive symptoms were evaluated with the Hamilton Depression Rating Scale and Montgomery-Asberg Depression Rating Scale. The Frontal Assessment Battery and the Stroop Color-Word Test Interference (Stroop T) were used to probe executive functions. Outcome measures were obtained at baseline, 4 weeks after the rTMS, as well as 3 months and 6 months after the end of the stimulation protocol.


After the active rTMS, patients showed a significant decrease in the scores at the depression rating scales that lasted for 6 months. A transient improvement was also observed at the Stroop T, although it did not persist in time.


High-frequency rTMS over the left DLPFC may have long-term antidepressant effect in drug-resistant MDD. TMS is a valuable tool for the add-on treatment of mood disorders and for the design of customized stimulation protocols.


Cortical excitability; drug-resistant major depression; neural plasticity; repetitive TMS

[Indexed for MEDLINE]

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