A Pilot Study of High-Frequency Transcranial Magnetic Stimulation for Bipolar Depression

Abstract

6 weeks of 10-Hz rTMS to the left dorsolateral prefrontal cortex Objective: Repetitive transcranial at 120% of motor threshold with magnetic stimulation (rTMS) is a 3,000 pulses per session in standard treatment approach for 4-second trains with intertrain major depressive disorder. There is intervals of 26 seconds. All patients growing clinical experience to were treated concurrently with a support the use of high-frequency mood stabilizer. The primary left-sided rTMS in bipolar depression. outcome measure was the This study collected open-label Montgomery-Asberg Depression safety and effectiveness data in a Rating Scale (MADRS). Response sample of patients with bipolar and remission were defined as depression. MADRS score reductions of ≥50% or score <10, respectively. We examined Methods: Thirty-one adults (13 male/ response, remission, and potential 18 female; mean age: 42.2 [14.3] years) contributing factors with multivariate with bipolar (I or II) depression verified and logistic regression models. by DSM-5 criteria were recruited at Sheppard Pratt and Mayo Results: The majority of patients with Clinic between August 2017 and bipolar depression reached response February 2020 for rTMS. Standardized (n = 27; 87.1%) and remission (n = 23; treatment protocols employed 74.2%). Older age and concurrent treatment with lithium were associated with higher MADRS scores throughout the treatment course (0.1±0.05, P= .05; 4.05±1.27, P=.003, respectively). Concurrent treatment with lamotrigine was associated with lower MADRS scores (−3.48±1.26, P=.01). Treatment with rTMS was safe and well tolerated. There were no completed suicides, induced manic episodes, or other serious adverse events. Conclusion: Although preliminary, the present findings are encouraging regarding the safety and effectiveness of 10-Hz rTMS for bipolar depression.