Authors:
Jha S; Chadda RK; Kumar N; Bal CS. Institution Jha, Shailesh. Department of Psychiatry, Institute of Human Behaviour & Allied Sciences, New Delhi 110095, India. Chadda, Rakesh K. Department of Psychiatry, All India Institute of Medical Sciences, New Delhi 110029, India. Electronic address: drrakeshchadda@gmail.com . Kumar, Nand. Department of Psychiatry, All India Institute of Medi cal Sciences, New Delhi 110029, India. Bal, C S. Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
Title:
Brain SPECT guided repetitive transcranial magnetic stimulation (rTMS) in treatment resistant major depressive disorder.
Source: Asian Journal of Psychiatry. 21:1-6, 2016 Jun.
Abstract: Repetitive transcranial magnetic stimulation (rTMS) has emerged as a potential treatment in treatment resistant major depressive disorder (MDD). However, there is no consensus about the exact site of stimulation for rTMS. Single-photon emission computed tomography (SPEC T) offers a potential technique in deciding the site of stimulation. The present study was conducted to assess the difference in outcome of brain SPEC T assisted rTMS versus standard protocol of twenty sessions of high frequency rTMS as add on treatment in 20 patients with treatment resistant MDD, given over a period of 4 weeks. Thirteen subjects (group I) received hi gh frequency rTMS over an area of hypoperfusion in the prefrontal cortex , as identified on SPECT, whereas 7 subjects (group II) were administered rTM S in the left dorsoslateral prefrontal cortex (DLPFC) area. Improvement was moni tored using standardized instruments. Patients in the group I showed a significantly better response compared to those in the group II. In group I, 46% of the subjects were responders on MADRS, 38% on BDI and 77% on CGI. The parallel figures of responders in Group II were 0% on MADRS, 14% on BDI and 43% on CGI. There were no remitters in the study . No significant untoward side effects were noticed. The study had l imitations of a small sample size and non-controlled design, and all the s ubjects were also receiving the standard antidepressant therapy. Administrat ion of rTMS over brain SPECT specified area of hypoperfusion may have a b etter clinical outcome compared to the standard protocol.
Copyright © 2016 Elsevier B.V. All rights reserved.
Publication Type Journal Article.
