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CNS Spectr. 2019 Jun;24(3):313-321. doi: 10.1017/S1092852917000670. Epub 2018 Feb 20.

Rhythmic low-field magnetic stimulation may improve depression by increasing brain-derived neurotrophic factor.

Author information

1
1The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing,China.
2
2Department of Psychiatry,The Zucker Hillside Hospital,Northwell Health,Glen Oaks,New York,United States.
3
3Unit of Psychiatry, Faculty of Health Sciences,University of Macau,Macao SAR,China.

Abstract

BACKGROUND:

Low-field magnetic stimulation (LFMS) has mood-elevating effect, and the increase of brain-derived neurotrophic factor (BDNF) is associated with antidepressant treatment. We evaluated the effects and association with BDNF of rhythmic LFMS in the treatment of major depressive disorder (MDD).

METHODS:

A total of 22 MDD patients were randomized to rhythmic alpha stimulation (RAS) or rhythmic delta stimulation (RDS), with 5 sessions per week, lasting for 6 weeks. Outcomes assessments included the 17-item Hamilton Depression Rating Scale (HAMD-17), the Hamilton Anxiety Rating Scale (HAMA), and the Clinical Global Impressions-Severity scale (CGI-S) at baseline and at weeks 1, 2, 3, 4, and 6. Serum BDNF level was measured at baseline and at weeks 2, 4, and 6.

RESULTS:

HAMD-17, HAMA, and CGI-S scores were significantly reduced with both RAS and RDS. RAS patients had numerically greater reductions in HAMD-17 scores than RDS patients (8.9 ± 7.4 vs. 6.2 ± 6.2, effect size [ES]=0.40), while RDS patients had greater improvement in HAMA scores (8.2 ± 8.0 vs. 5.3 ± 5.8, ES=0.42). RAS was associated with clinically relevant advantages in response (54.5% vs. 18.2%, number-needed-to-treat [NNT]=3) and remission (36.4% vs. 9.1%, NNT=4). BDNF increased significantly during the 6-week study period (p<0.05), with greater increases in RAS at weeks 4 and 6 (ES=0.66-0.76) and statistical superiority at week 2 (p=0.034, ES=1.23). Baseline BDNF in the 8 responders (24.8±9.0 ng/ml) was lower than in the 14 nonresponders (31.1±7.3 ng/ml, p=0.083, ES=-0.79), and BDNF increased more in responders (8.9±7.8 ng/ml) than in nonresponders (1.8±3.5 ng/ml, p=0.044). The change in BDNF at week 2 was the most strongly predicted response (p=0.016).

CONCLUSIONS:

Rhythmic LFMS was effective for MDD. BDNF may moderate/mediate the efficacy of LFMS.

KEYWORDS:

Major depressive disorder; brain-derived neurotrophic factor; mediator; moderator; rhythmic magnetic stimulation

PMID:
29460712
DOI:
10.1017/S1092852917000670

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