Augmentative transcranial magnetic stimulation (TMS) combined with brain navigation in drug-resistant rapid cycling bipolar depression: A case report of acute and maintenance efficacy

Research output: Contribution to journalArticle

Abstract

The efficacy of transcranial magnetic stimulation (TMS) has been poorly investigated in the acute and maintenance treatment of bipolar depression. The present case supports the efficacy of low-frequency repetitive TMS (rTMS) of the right dorsolateral pre-frontal cortex (RDLPFC) combined to brain navigation in a drug-resistant, bipolar depressed subject with rapid cycling. While continuing the pharmacological treatment at stable doses, the patient was stimulated for 3 weeks at 1 Hz, 110% of motor threshold, 300 stimuli/day showing a significant improvement on the Hamilton Depression Rating Scale (HDRS21), the MontgomeryAsberg Depression Rating Scale (MADRS) and the Clinical Global Impression, improvement scale (CGI-I) total scores. On completion of the 3-week rTMS, the patient was treated with periodic maintenance sessions of rTMS at the same parameters of acute phase for an additional 6 months, at the end of which the therapeutic gains were maintained according to rating scales scores. Larger controlled trials assessing the acute and maintenance efficacy of rTMS in bipolar depression are needed.

Original languageEnglish
Pages (from-to)673-676
Number of pages4
JournalWorld Journal of Biological Psychiatry
Volume10
Issue number4 PART 2
DOIs
Publication statusPublished - 2009

Fingerprint

Transcranial Magnetic Stimulation
Bipolar Disorder
Maintenance
Brain
Pharmaceutical Preparations
Depression
Frontal Lobe
Therapeutics
Pharmacology

Keywords

  • Bipolar depression
  • Brain navigation
  • Right dorsolateral pre-frontal cortex (RDLPFC)
  • Transcranial magnetic stimulation (TMS)

ASJC Scopus subject areas

  • Medicine(all)
  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

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abstract = "The efficacy of transcranial magnetic stimulation (TMS) has been poorly investigated in the acute and maintenance treatment of bipolar depression. The present case supports the efficacy of low-frequency repetitive TMS (rTMS) of the right dorsolateral pre-frontal cortex (RDLPFC) combined to brain navigation in a drug-resistant, bipolar depressed subject with rapid cycling. While continuing the pharmacological treatment at stable doses, the patient was stimulated for 3 weeks at 1 Hz, 110{\%} of motor threshold, 300 stimuli/day showing a significant improvement on the Hamilton Depression Rating Scale (HDRS21), the MontgomeryAsberg Depression Rating Scale (MADRS) and the Clinical Global Impression, improvement scale (CGI-I) total scores. On completion of the 3-week rTMS, the patient was treated with periodic maintenance sessions of rTMS at the same parameters of acute phase for an additional 6 months, at the end of which the therapeutic gains were maintained according to rating scales scores. Larger controlled trials assessing the acute and maintenance efficacy of rTMS in bipolar depression are needed.",
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