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Equivalent beneficial effects of unilateral and bilateral prefrontal cortex transcranial magnetic stimulation in a large randomized trial in treatment-resistant major depression

Fitzgerald, Paul B., Hoy, Kate E., Singh, Ajeet, Gunewardene, Ranil, Slack, Christopher, Ibrahim, Samir, Hall, Phillip J. and Daskalakis, Z. Jeff 2013, Equivalent beneficial effects of unilateral and bilateral prefrontal cortex transcranial magnetic stimulation in a large randomized trial in treatment-resistant major depression, International journal of neuropsychopharmacology, vol. 16, no. 9, pp. 1975-1984, doi: 10.1017/S1461145713000369.

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Title Equivalent beneficial effects of unilateral and bilateral prefrontal cortex transcranial magnetic stimulation in a large randomized trial in treatment-resistant major depression
Author(s) Fitzgerald, Paul B.
Hoy, Kate E.
Singh, Ajeet
Gunewardene, Ranil
Slack, Christopher
Ibrahim, Samir
Hall, Phillip J.
Daskalakis, Z. Jeff
Journal name International journal of neuropsychopharmacology
Volume number 16
Issue number 9
Start page 1975
End page 1984
Total pages 10
Publisher Oxford University Press
Place of publication Oxford, Eng.
Publication date 2013-10-01
ISSN 1461-1457
1469-5111
Keyword(s) antidepressant
depression
prefrontal cortex
remission
repetitive transcranial magnetic stimulation
response
Adult
Australia
Chi-Square Distribution
Depressive Disorder, Major
Depressive Disorder, Treatment-Resistant
Double-Blind Method
Female
Humans
Linear Models
Male
Middle Aged
Psychiatric Status Rating Scales
Time Factors
Transcranial Magnetic Stimulation
Treatment Outcome
Science & Technology
Life Sciences & Biomedicine
Clinical Neurology
Neurosciences
Pharmacology & Pharmacy
Psychiatry
Neurosciences & Neurology
PSYCHIATRY, SCI
LOW-FREQUENCY
DOUBLE-BLIND
PSYCHIATRIC-DISORDERS
PRIMING STIMULATION
ECONOMIC BURDEN
EFFICACY
METAANALYSIS
RTMS
INVENTORY
MULTISITE
Summary Repetitive transcranial magnetic stimulation treatment (rTMS) is an effective treatment for depression but the optimal methods of administration have yet to be determined. Recent studies have produced conflicting results as to whether unilateral rTMS is more or less effective than sequentially applied bilateral rTMS. To address this we conducted a trial comparing sequential bilateral rTMS to right-sided unilateral rTMS using a priming protocol. Patients with treatment-resistant depression (n = 179) were enrolled in a two-arm randomized controlled trial across a 4-wk time period. The primary outcome assessment was the Hamilton Depression Rating Scale. Overall, there was a substantial response rate of >50% (and a 40% remission rate); however, there were no significant differences in clinical response between the two treatment groups. rTMS was well tolerated with a very low discontinuation rate. There was no relationship between response in the current trial and previous response, or non-response, to electroconvulsive therapy. We found no significant differences in clinical response between sequential bilateral rTMS and right-sided unilateral rTMS applied with a priming protocol. The results of this study do not support superior efficacy of bilateral rTMS and instead suggest that other approaches should be explored to increase treatment efficacy.
Language eng
DOI 10.1017/S1461145713000369
Field of Research 110999 Neurosciences not elsewhere classified
11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
Socio Economic Objective 970117 Expanding Knowledge in Psychology and Cognitive Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2013, CINP
Persistent URL http://hdl.handle.net/10536/DRO/DU:30088076

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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