Low-frequency rTMS inhibits the anti-depressive effect of ECT.:  A pilot study

Poul Erik Buchholtz; Mahmoud Ashkanian; Simon Hjerrild; Line Kirstine Hauptmann; Torben Albert Devantier; Paulina Jensen; Sanne Wissing; Mette Viller Thorgaard; Laerke Bjerager; Julie Lund; Anja Johnsen Alrø; Maria Simonsen Speed; Rene Børge Korsgaard Brund; Poul Videbech

doi:10.1017/neu.2020.28

Low-frequency rTMS inhibits the anti-depressive effect of ECT. A pilot study

Poul Erik Buchholtz, Mahmoud Ashkanian, Simon Hjerrild, Line Kirstine Hauptmann, Torben Albert Devantier, Paulina Jensen, Sanne Wissing, Mette Viller Thorgaard, Laerke Bjerager, Julie Lund, Anja Johnsen Alrø, Maria Simonsen Speed, Rene Børge Korsgaard Brund, Poul Videbech

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

5 Citationer (Scopus)

Abstract

OBJECTIVE: Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex has been shown to have a statistically and clinically significant anti-depressant effect. The present pilot study was carried out to investigate if right prefrontal low-frequency rTMS as an add-on to electroconvulsive therapy (ECT) accelerates the anti-depressant effect and reduces cognitive side effects.

METHODS: In this randomised, controlled, double-blind study, thirty-five patients with major depression were allocated to ECT+placebo or ECT+low-frequency right prefrontal rTMS. The severity of depression was evaluated during the course using the Hamilton scale for depression (the 17-item as well as the 6-item scale) and the major depression inventory (MDI). Furthermore, neuropsychological assessment of cognitive function was carried out.

RESULTS: The study revealed no significant difference between the two groups for any of the outcomes, but with a visible trend to lower scores for MDI after treatment in the placebo group. The negative impact of ECT on neurocognitive functions was short-lived, and scores on logical memory were significantly improved compared to baseline 4 weeks after last treatment. The ECT-rTMS group revealed generally less impairment of cognitive functions than the ECT-placebo group.

CONCLUSION: The addition of low-frequency rTMS as an add-on to ECT treatment did not result in an accelerated response. On the contrary, the results suggest that low-frequency rTMS could inhibit the anti-depressant effect of ECT.

Originalsprog	Engelsk
Tidsskrift	Acta Neuropsychiatrica
Vol/bind	32
Udgave nummer	6
Sider (fra-til)	328 - 338
ISSN	0924-2708
DOI	https://doi.org/10.1017/neu.2020.28
Status	Udgivet - 2020

Adgang til dokumentet

10.1017/neu.2020.28

Citationsformater

Buchholtz, P. E., Ashkanian, M., Hjerrild, S., Hauptmann, L. K., Devantier, T. A., Jensen, P., Wissing, S., Thorgaard, M. V., Bjerager, L., Lund, J., Alrø, A. J., Speed, M. S., Brund, R. B. K., & Videbech, P. (2020). Low-frequency rTMS inhibits the anti-depressive effect of ECT. A pilot study. Acta Neuropsychiatrica, 32(6), 328 - 338. https://doi.org/10.1017/neu.2020.28

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title = "Low-frequency rTMS inhibits the anti-depressive effect of ECT.: A pilot study",

abstract = "OBJECTIVE: Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex has been shown to have a statistically and clinically significant anti-depressant effect. The present pilot study was carried out to investigate if right prefrontal low-frequency rTMS as an add-on to electroconvulsive therapy (ECT) accelerates the anti-depressant effect and reduces cognitive side effects.METHODS: In this randomised, controlled, double-blind study, thirty-five patients with major depression were allocated to ECT+placebo or ECT+low-frequency right prefrontal rTMS. The severity of depression was evaluated during the course using the Hamilton scale for depression (the 17-item as well as the 6-item scale) and the major depression inventory (MDI). Furthermore, neuropsychological assessment of cognitive function was carried out.RESULTS: The study revealed no significant difference between the two groups for any of the outcomes, but with a visible trend to lower scores for MDI after treatment in the placebo group. The negative impact of ECT on neurocognitive functions was short-lived, and scores on logical memory were significantly improved compared to baseline 4 weeks after last treatment. The ECT-rTMS group revealed generally less impairment of cognitive functions than the ECT-placebo group.CONCLUSION: The addition of low-frequency rTMS as an add-on to ECT treatment did not result in an accelerated response. On the contrary, the results suggest that low-frequency rTMS could inhibit the anti-depressant effect of ECT.",

author = "Buchholtz, {Poul Erik} and Mahmoud Ashkanian and Simon Hjerrild and Hauptmann, {Line Kirstine} and Devantier, {Torben Albert} and Paulina Jensen and Sanne Wissing and Thorgaard, {Mette Viller} and Laerke Bjerager and Julie Lund and Alr{\o}, {Anja Johnsen} and Speed, {Maria Simonsen} and Brund, {Rene B{\o}rge Korsgaard} and Poul Videbech",

year = "2020",

doi = "10.1017/neu.2020.28",

language = "English",

volume = "32",

pages = "328 -- 338",

journal = "Acta Neuropsychiatrica",

issn = "0924-2708",

publisher = "Cambridge University Press",

number = "6",

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TY - JOUR

T1 - Low-frequency rTMS inhibits the anti-depressive effect of ECT.

T2 - A pilot study

AU - Buchholtz, Poul Erik

AU - Ashkanian, Mahmoud

AU - Hjerrild, Simon

AU - Hauptmann, Line Kirstine

AU - Devantier, Torben Albert

AU - Jensen, Paulina

AU - Wissing, Sanne

AU - Thorgaard, Mette Viller

AU - Bjerager, Laerke

AU - Lund, Julie

AU - Alrø, Anja Johnsen

AU - Speed, Maria Simonsen

AU - Brund, Rene Børge Korsgaard

AU - Videbech, Poul

PY - 2020

Y1 - 2020

N2 - OBJECTIVE: Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex has been shown to have a statistically and clinically significant anti-depressant effect. The present pilot study was carried out to investigate if right prefrontal low-frequency rTMS as an add-on to electroconvulsive therapy (ECT) accelerates the anti-depressant effect and reduces cognitive side effects.METHODS: In this randomised, controlled, double-blind study, thirty-five patients with major depression were allocated to ECT+placebo or ECT+low-frequency right prefrontal rTMS. The severity of depression was evaluated during the course using the Hamilton scale for depression (the 17-item as well as the 6-item scale) and the major depression inventory (MDI). Furthermore, neuropsychological assessment of cognitive function was carried out.RESULTS: The study revealed no significant difference between the two groups for any of the outcomes, but with a visible trend to lower scores for MDI after treatment in the placebo group. The negative impact of ECT on neurocognitive functions was short-lived, and scores on logical memory were significantly improved compared to baseline 4 weeks after last treatment. The ECT-rTMS group revealed generally less impairment of cognitive functions than the ECT-placebo group.CONCLUSION: The addition of low-frequency rTMS as an add-on to ECT treatment did not result in an accelerated response. On the contrary, the results suggest that low-frequency rTMS could inhibit the anti-depressant effect of ECT.

AB - OBJECTIVE: Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex has been shown to have a statistically and clinically significant anti-depressant effect. The present pilot study was carried out to investigate if right prefrontal low-frequency rTMS as an add-on to electroconvulsive therapy (ECT) accelerates the anti-depressant effect and reduces cognitive side effects.METHODS: In this randomised, controlled, double-blind study, thirty-five patients with major depression were allocated to ECT+placebo or ECT+low-frequency right prefrontal rTMS. The severity of depression was evaluated during the course using the Hamilton scale for depression (the 17-item as well as the 6-item scale) and the major depression inventory (MDI). Furthermore, neuropsychological assessment of cognitive function was carried out.RESULTS: The study revealed no significant difference between the two groups for any of the outcomes, but with a visible trend to lower scores for MDI after treatment in the placebo group. The negative impact of ECT on neurocognitive functions was short-lived, and scores on logical memory were significantly improved compared to baseline 4 weeks after last treatment. The ECT-rTMS group revealed generally less impairment of cognitive functions than the ECT-placebo group.CONCLUSION: The addition of low-frequency rTMS as an add-on to ECT treatment did not result in an accelerated response. On the contrary, the results suggest that low-frequency rTMS could inhibit the anti-depressant effect of ECT.

U2 - 10.1017/neu.2020.28

DO - 10.1017/neu.2020.28

M3 - Journal article

C2 - 32713367

SN - 0924-2708

VL - 32

SP - 328

EP - 338

JO - Acta Neuropsychiatrica

JF - Acta Neuropsychiatrica

IS - 6

ER -