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Academic Journal
BIPOLAR DISORDER
| Title: |
Intensive high-frequency repetitive transcranial magnetic stimulation treatment in an electroconvulsive shock therapy-resistant bipolar I patient with mixed episode
| | Date: | 2010 | | Author(s): |
Zeeuws D, De Rycker K, De Raedt R, Matthieu De Beyne M, Baeken C, Vanderbruggen N
| | Source: | Brain Stimulation | | Abstract: |
This case report describes a 52-year-old woman who received a diagnosis of bipolar I disorder of the mixed type, resistant to bilateral electroconvulsive shock therapy (ECT) and successfully treated with intensive left-sided high frequency repetitive transcranial magnetic stimulation (HF-rTMS).
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| | Title: |
Augmentative repetitive navigated transcranial magnetic stimulation (rTMS) in drug-resistant bipolar depression
| | Date: | 2010 | | Author(s): |
Dell_Osso B, Mundo E, D_Urso N, Pozzoli S, Buoli M, Ciabatti MT,
Rosanova M, Massimini M, Bellina V, Mariotti M, Altamura AC.
| | Source: | Bipolar Disorders | | Abstract: |
Objectives: The efficacy of transcranial magnetic stimulation (TMS)has been poorly investigated in bipolar depression. The present studyaimed to assess the efficacy of low-frequency repetitive TMS (rTMS) of the right dorsolateral prefrontal cortex (DLPFC) combined with brain navigation in a sample of bipolar depressed subjects.
Methods: Eleven subjects with bipolar I or bipolar II disorder and major depressive episode who did not respond to previous pharmacological treatment were treated with three weeks of open-label rTMS at 1 Hz, 110% of motor threshold, 300 stimuli ⁄ day.
Results: All subjects completed the trial showing a statistically significant improvement on the 21-item Hamilton Depression Rating Scale (HAM-D), Montgomery-A˚ sberg Depression Rating Scale, and Clinical Global Impression severity of illness scale (ANOVAs with repeated measures: F = 22.36, p < 0.0001; F = 12.66, p < 0.0001; and F = 10.41, p < 0.0001, respectively). In addition, stimulation response, defined as an endpoint HAM-D score reduction of ‡50% compared to
baseline, was achieved by 6 out of 11 subjects, 4 of whom were considered remitters (HAM-D endpoint score £ 8). Partial response (endpoint HAM-D score reduction between 25% and 50%) was achieved by 3 ⁄ 11 patients. No manic ⁄ hypomanic activation was detected during the treatment according to Young Mania Rating Scale scores
(ANOVAs with repeated measures: F = 0.62, p = 0.61). Side effects were slight and were limited to the first days of treatment.
Conclusions: Augmentative low-frequency rTMS of the right DLPFC combined with brain navigation was effective and well tolerated in a small sample of drug-resistant bipolar depressive patients, even though the lack of a sham controlled group limits confidence in the results.
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| | Title: |
Augmentative repetitive navigated transcranial
magnetic stimulation (rTMS) in drug-resistant
bipolar depression | | Date: | 2009 | | Author(s): |
Dell'Osso B, Mundo E, D'Urso N, Pozzoli S, Buoli M, Ciabatti MT,
Rosanova M, Massimini M, Bellina V, Mariotti M, Altamura AC.
| | Source: | Bipolar Disorders 2009: 11: 76–81 | | Keywords: |
bipolar depression –brain navigation –
DLPFC – dorsolateral prefrontal cortex – TMS –
transcranial magnetic stimulation
| | Abstract: |
Objectives: The efficacy of transcranial magnetic stimulation (TMS)
has been poorly investigated in bipolar depression. The present study
aimed to assess the efficacy of low-frequency repetitive TMS (rTMS) of
the right dorsolateral prefrontal cortex (DLPFC) combined with brain
navigation in a sample of bipolar depressed subjects.
Methods: Eleven subjects with bipolar I or bipolar II disorder and
major depressive episode who did not respond to previous
pharmacological treatment were treated with three weeks of open-label
rTMS at 1 Hz, 110% of motor threshold, 300 stimuli ⁄ day.
Results: All subjects completed the trial showing a statistically
significant improvement on the 21-item Hamilton Depression Rating
Scale (HAM-D), Montgomery-A˚ sberg Depression Rating Scale, and
Clinical Global Impression severity of illness scale (ANOVAs with
repeated measures: F = 22.36, p < 0.0001; F = 12.66, p < 0.0001; and
F = 10.41, p < 0.0001, respectively). In addition, stimulation response,
defined as an endpoint HAM-D score reduction of ‡50% compared to
baseline, was achieved by 6 out of 11 subjects, 4 of whom were
considered remitters (HAM-D endpoint score £ 8). Partial response
(endpoint HAM-D score reduction between 25% and 50%) was
achieved by 3 ⁄ 11 patients. No manic ⁄ hypomanic activation was detected
during the treatment according to Young Mania Rating Scale scores
(ANOVAs with repeated measures: F = 0.62, p = 0.61). Side effects
were slight and were limited to the first days of treatment.
Conclusions: Augmentative low-frequency rTMS of the right DLPFC
combined with brain navigation was effective and well tolerated in a
small sample of drug-resistant bipolar depressive patients, even though
the lack of a sham controlled group limits confidence in the results.
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