Makkos A; Pal E; Aschermann Z; Janszky J; Balazs E; Takacs K; Karadi K; Komoly S; Kovacs N. Institution Makkos, Attila. Doctoral School of Clinical Neuroscience, University of Px00E9;cs, Px00E9;cs, Hungary.
High-Frequency Repetitive Transcranial Magnetic Stimulation Can Improve Depression in Parkinson's Disease: A Randomized, Double-Blind, Placebo-Controlled Study.
Source: Neuropsychobiology. 73(3):169-77, 2016.
BACKGROUND: A recent evidence-based guideline demonstrated that bilat eral repetitive transcranial magnetic stimulation (rTMS) over the moto r cortex (M1) can improve motor symptoms of Parkinson's disease (PD) . We conducted a randomized, double-blind, placebo-controlled study to ev aluate the impact of bilateral M1 rTMS on depression in PD.
METHODS: Forty-six patients with PD and mild- to -moderate depression were randomly assigned to active (n = 23) and sham (n = 23) rTMS. Two patients in the sham group did not complete the protocol because of rea sons unrelated to the study. High-frequency rTMS was applied over the primary motor cortex bilaterally for 10 days. An investigator blind ed to the treatment performed three video-taped examinations on each patient: b efore stimulation (baseline), and 1 day (short-term effect) and 30 d ays after the treatment session ended (long-term effect). The primary end point was the changes in depression, while secondary end points includ ed health-related quality of life scales and Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS).
RESULTS: In the actively treated group, not only did the severit y of depression improve (from 17 to 7 points, Montgomery-Asberg D epression Rating Scale, median values, p < 0.001), but also the health-relat ed quality of life (from 25.4 to 16.9 points, PDQ-39 summary index, median values, p < 0.001). Besides, we could also demonstrate an impr ovement in MDS -UPDRS Motor Examination (from 26 to 20 points, median values, p < 0.05). In the sham-treated group, none of the examined test s and scales improved significantly after treatment.
CONCLUSIONS: Our results demonstrate the beneficial effects of high-frequency bilateral M1 rTMS on depression and health-relat ed quality of life in PD. However, this effect of rTMS should also be con firmed in patients with severe depression by further clinical trials.
Copyright © 2016 S. Karger AG, Basel.
Publication Type: Journal Article. Randomized Controlled Trial.