A Pilot Study of High-Frequency Transcranial Magnetic Stimulation for Bipolar Depression.

Autor:	Aaronson ST; Institute for Advanced Diagnostics and Therapeutics, Sheppard Pratt Health System, Baltimore, Maryland.; Corresponding Author: Scott T. Aaronson, MD, Institute for Advanced Diagnostics and Therapeutics, Sheppard Pratt Health System, 6501 N Charles St, Baltimore, MD 21204 (SAaronson@sheppardpratt.org)., Goldwaser EL; Department of Psychiatry, Interventional Psychiatry Program, Weill Cornell Medicine, New York, New York., Croarkin PE; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota., Geske JR; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota., LeMahieu A; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota., Sklar JH; Institute for Advanced Diagnostics and Therapeutics, Sheppard Pratt Health System, Baltimore, Maryland., Kung S; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.
Jazyk:	angličtina
Zdroj:	The Journal of clinical psychiatry [J Clin Psychiatry] 2024 May 20; Vol. 85 (2). Date of Electronic Publication: 2024 May 20.
DOI:	10.4088/JCP.23m15056
Abstrakt:	Objective: Repetitive transcranial magnetic stimulation (rTMS) is a standard treatment approach for major depressive disorder. There is growing clinical experience to support the use of high-frequency left-sided rTMS in bipolar depression. This study collected open-label safety and effectiveness data in a sample of patients with bipolar depression. Methods: Thirty-one adults (13 male/ 18 female; mean age: 42.2 [14.3] years) with bipolar (I or II) depression verified by DSM-5 criteria were recruited at Sheppard Pratt and Mayo Clinic between August 2017 and February 2020 for rTMS. Standardized treatment protocols employed 6 weeks of 10-Hz rTMS to the left dorsolateral prefrontal cortex at 120% of motor threshold with 3,000 pulses per session in 4-second trains with intertrain intervals of 26 seconds. All patients were treated concurrently with a mood stabilizer. The primary outcome measure was the Montgomery-Asberg Depression Rating Scale (MADRS). Response and remission were defined as MADRS score reductions of ≥50% or score <10, respectively. We examined response, remission, and potential contributing factors with multivariate and logistic regression models. Results: The majority of patients with bipolar depression reached response (n = 27; 87.1%) and remission (n = 23; 74.2%). Older age and concurrent treatment with lithium were associated with higher MADRS scores throughout the treatment course (0.1 ± 0.05, P =.05; 4.05 ± 1.27, P = .003, respectively). Concurrent treatment with lamotrigine was associated with lower MADRS scores (-3.48 ± 1.26, P = .01). Treatment with rTMS was safe and well tolerated. There were no completed suicides, induced manic episodes, or other serious adverse events. Conclusion: Although preliminary, the present findings are encouraging regarding the safety and effectiveness of 10-Hz rTMS for bipolar depression. Trial Registration: ClinicalTrials.gov identifier: NCT02640950. (© Copyright 2024 Physicians Postgraduate Press, Inc.)
Databáze:	MEDLINE
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