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HF-rTMS treatment in medication-resistant melancholic depression: results from 18FDG-PET brain imaging.
Tijdschriftbijdrage - Tijdschriftartikel
INTRODUCTION: High frequency repetitive transcranial magnetic stimulation (HF-rTMS) of the left dorsolateral prefrontal cortex (DLPFC) might be a promising strategy to treat depression, but not all patients show a positive outcome.
OBJECTIVE: In this open study, we evaluate whether a favorable HF-rTMS treatment outcome could be predicted by baseline prefrontal brain glucose metabolism (CMRglc), measured by 18fluorodeoxyglucose positron emission tomography (18FDG-PET).
METHODS: A sample of 21 antidepressant-free, treatment-resistant depression (TRD) patients of the melancholic subtype received 10 sessions of HF-rTMS delivered on the left DLPFC. Patients underwent a static 18FDG-PET before and after HF-rTMS treatment.
RESULTS: Forty-three percent of the patients showed a reduction of at least 50% on their Hamilton Rating Scale for Depression scores. Higher baseline metabolic activities in the DLPFC and the anterior cingulate cortex (ACC) were associated with better clinical outcome. Successful HF-rTMS treatment was related to metabolic changes in subdivisions of the ACC (Brodmann areas 24 and 32).
CONCLUSION: This biological impact of HF-rTMS on regional brain CMRglc explains to some extent how HF-rTMS may improve moods in TRD patients. Larger sham-controlled HF-rTMS treatment studies are needed to confirm these results.
OBJECTIVE: In this open study, we evaluate whether a favorable HF-rTMS treatment outcome could be predicted by baseline prefrontal brain glucose metabolism (CMRglc), measured by 18fluorodeoxyglucose positron emission tomography (18FDG-PET).
METHODS: A sample of 21 antidepressant-free, treatment-resistant depression (TRD) patients of the melancholic subtype received 10 sessions of HF-rTMS delivered on the left DLPFC. Patients underwent a static 18FDG-PET before and after HF-rTMS treatment.
RESULTS: Forty-three percent of the patients showed a reduction of at least 50% on their Hamilton Rating Scale for Depression scores. Higher baseline metabolic activities in the DLPFC and the anterior cingulate cortex (ACC) were associated with better clinical outcome. Successful HF-rTMS treatment was related to metabolic changes in subdivisions of the ACC (Brodmann areas 24 and 32).
CONCLUSION: This biological impact of HF-rTMS on regional brain CMRglc explains to some extent how HF-rTMS may improve moods in TRD patients. Larger sham-controlled HF-rTMS treatment studies are needed to confirm these results.
Tijdschrift: C N S Spectrums : The International Journal of Neuropsychiatric Medicine
ISSN: 1092-8529
Issue: 8
Volume: 14
Pagina's: 439-448
Jaar van publicatie:2009
Trefwoorden:Adult, Antidepressive Agents/therapeutic use, Brain/radionuclide imaging, Depressive Disorder, Major/drug therapy, Depressive Disorder, Major/radionuclide imaging, Depressive Disorder, Major/therapy, Drug Resistance, Female, Fluorodeoxyglucose F18, Humans, Male, Middle Aged, Positron-Emission Tomography, Radiopharmaceuticals, Transcranial Magnetic Stimulation, Treatment Outcome, Psychiatrie en neurologie
Toegankelijkheid:Closed