A functional magnetic resonance imaging study of the effects of low frequency right prefrontal transcranial magnetic stimulation in depression

Paul B. Fitzgerald, Anusha Sritharan, Zafiris J. Daskalakis, Anthony R. De Castella, Jayashri Kulkarni, Gary Egan

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The study aimed to explore the biological effects of low-frequency repetitive transcranial magnetic stimulation (LFR-TMS) treatment applied to the right prefrontal cortex, comparing this with the effects of high-frequency left-sided (HFL-TMS) in patients with treatment-resistant depression. Twenty-six patients with treatment-resistant depression were randomized to receive either daily LFR-TMS or HFL-TMS treatment for 3 weeks and underwent functional magnetic resonance imaging during a planning task before and after treatment. Patients responded clinically to both forms of treatment with no difference in the degree of response (F1,24 = 0.65;P > 0.05). Low-frequency repetitive transcranial magnetic stimulation resulted in no overall change in task-related activation. However, responders to LFR-TMS demonstrated a bilateral decrease in activity in middle frontal gyrus. In contrast, HFL-TMS produced an increase in activation in left precuneus with responders showing increased activation in several additional regions. Response to LFR-TMS is associated with a bilateral reduction in frontal activation that does not seem to be a nonspecific effect of treatment and differs from the response to HFL-TMS.

Original languageEnglish
Pages (from-to)488-492
Number of pages5
JournalJournal of Clinical Psychopharmacology
Issue number5
Publication statusPublished - 1 Oct 2007

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