Magnetic Resonance Imaging-Guided, Open-Label, High-Frequency Repetitive Transcranial Magnetic Stimulation for Adolescents with Major Depressive Disorder
| Autor: | Shirlene Sampson, Christopher A. Wall, Mandie Maroney-Smith, Paul E. Croarkin, Mark A. Frye, Laura M. Haugen, Joshua M. Baruth, John D. Port |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.medical_treatment Population Prefrontal Cortex Context (language use) Severity of Illness Index behavioral disciplines and activities Depressive Disorder Treatment-Resistant 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation mental disorders medicine Humans Pharmacology (medical) education Prefrontal cortex Psychiatry Psychiatric Status Rating Scales Depressive Disorder Major education.field_of_study medicine.diagnostic_test Magnetic resonance imaging Original Articles medicine.disease Magnetic Resonance Imaging Transcranial Magnetic Stimulation 030227 psychiatry Dorsolateral prefrontal cortex Transcranial magnetic stimulation Psychiatry and Mental health Treatment Outcome medicine.anatomical_structure nervous system Tolerability Pediatrics Perinatology and Child Health Major depressive disorder Female Psychology 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of Child and Adolescent Psychopharmacology. 26:582-589 |
| ISSN: | 1557-8992 1044-5463 |
| Popis: | Preliminary studies suggest that repetitive transcranial magnetic stimulation (rTMS) may be an effective and tolerable intervention for adolescents with treatment-resistant depression. There is limited rationale to inform coil placement for rTMS dosing in this population. We sought to examine and compare three localization techniques for coil placement in the context of an open-label trial of high-frequency rTMS for adolescents with treatment-resistant depression.Ten adolescents with treatment-resistant depression were enrolled in an open-label trial of high-frequency rTMS. Participants were offered 30 rTMS sessions (10 Hz, 120% motor threshold, left 3000 pulses applied to the dorsolateral prefrontal cortex) over 6-8 weeks. Coil placement for treatment was MRI guided. The scalp location for treatment was compared with the locations identified with standard 5 cm rule and Beam F3 methods.Seven adolescents completed 30 rTMS sessions. No safety or tolerability concerns were identified. Depression severity as assessed with the Children's Depression Rating Scale Revised improved from baseline to treatment 10, treatment 20, and treatment 30. Gains in depressive symptom improvement were maintained at 6 month follow-up visits. An MRI-guided approach for coil localization was feasible and efficient. Our results suggest that the 5 cm rule, Beam F3, and the MRI-guided localization approaches provided variable scalp targets for rTMS treatment.Open-label, high-frequency rTMS was feasible, tolerable, and effective for adolescents with treatment-resistant depression. Larger, blinded, sham-controlled trials are needed for definitive safety and efficacy data. Further efforts to understand optimal delivery, dosing, and biomarker development for rTMS treatments of adolescent depression are warranted. |
| Databáze: | OpenAIRE |
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