Journal article
A Randomized Trial of rTMS Targeted with MRI Based Neuro-Navigation in Treatment-Resistant Depression
Neuropsychopharmacology (New York, N.Y.), Vol.34(5), pp.1255-1262
04/01/2009
DOI: 10.1038/npp.2008.233
PMID: 19145228
Abstract
The aim of this study is to investigate whether repetitive transcranial magnetic stimulation (rTMS) targeted to a specific site in the dorsolateral prefrontal cortex (DLPFC), with a neuro-navigational method based on structural MRI, would be more effective than rTMS applied using the standard localization technique. Fifty-one patients with treatment-resistant depression were randomized to receive a 3-week course (with a potential 1-week extension) of high-frequency (10 Hz) left-sided rTMS. Thirty trains (5 s duration) were applied daily 5 days per week at 100% of the resting motor threshold. Treatment was targeted with either the standard 5 cm technique (n = 27) or using a neuro-navigational approach (n = 24). This involved localizing the scalp location that corresponds to a specific site at the junction of Brodmann areas 46 and 9 in the DLPFC based on each individual subject's MRI scan. There was an overall significant reduction in the Montgomery-Asberg Depression Rating Scale scores over the course of the trial, and a better outcome in the targeted group compared with the standard localization group at 4 weeks (p = 0.02). Significant differences were also found on secondary outcome variables. The use of neuro-navigational methods to target a specific DLPFC site appears to enhance response to rTMS treatment in depression. Further research is required to confirm this in larger samples, or to establish whether an alternate method based on surface anatomy, including measurement from motor cortex, can be substituted for the standard 5 cm method.
Details
- Title: Subtitle
- A Randomized Trial of rTMS Targeted with MRI Based Neuro-Navigation in Treatment-Resistant Depression
- Creators
- Paul B. Fitzgerald - Monash Alfred Psychiatry Research centreKate Hoy - Monash Alfred Psychiatry Research centreSusan McQueen - Monash Alfred Psychiatry Research centreJerome J. Maller - Monash Alfred Psychiatry Research centreSally Herring - Monash Alfred Psychiatry Research centreRebecca Segrave - Monash Alfred Psychiatry Research centreMichael Bailey - The Alfred HospitalGreg Been - Monash Alfred Psychiatry Research centreJayashri Kulkarni - Monash Alfred Psychiatry Research centreZafiris J. Daskalakis - Centre for Addiction and Mental Health
- Resource Type
- Journal article
- Publication Details
- Neuropsychopharmacology (New York, N.Y.), Vol.34(5), pp.1255-1262
- DOI
- 10.1038/npp.2008.233
- PMID
- 19145228
- NLM abbreviation
- Neuropsychopharmacology
- ISSN
- 0893-133X
- eISSN
- 1740-634X
- Publisher
- Springer Nature
- Number of pages
- 8
- Grant note
- Neurosciences Australia Clinical Neurobiology of Psychiatry Platform NARSAD; NARSAD 436710 / National Health and Medical Research Council (NHMRC); National Health & Medical Research Council (NHMRC) of Australia
- Language
- English
- Date published
- 04/01/2009
- Academic Unit
- Radiology
- Record Identifier
- 9984848429302771
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