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- Title
HF-rTMS Treatment in Resistant Melancholic Medication-Depression: Results from <sup>18</sup>FDG-PET Brain Imaging.
- Authors
Baeken, Chris; de Raedt, Rudi; van Hove, Christian; Clerinx, Peter; de Mey, Johan; Bossuyt, Axel
- Abstract
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 (CMRgIc), 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.
- Subjects
BRAIN metabolism; TRANSCRANIAL magnetic stimulation; BRAIN imaging; REPEATED sequence (Genetics); HEALTH outcome assessment; MEDICAL imaging systems; LOVESICKNESS
- Publication
CNS Spectrums: The International Journal of Neuropsychiatric Medicine, 2009, Vol 14, Issue 8, p439
- ISSN
1092-8529
- Publication type
Article
- DOI
10.1017/S1092852900020411