PMID- 19133969
OWN - NLM
STAT- MEDLINE
DCOM- 20090406
LR  - 20211012
IS  - 1399-5618 (Electronic)
IS  - 1398-5647 (Linking)
VI  - 11
IP  - 1
DP  - 2009 Feb
TI  - Augmentative repetitive navigated transcranial magnetic stimulation (rTMS) in 
      drug-resistant bipolar depression.
PG  - 76-81
LID - 10.1111/j.1399-5618.2008.00651.x [doi]
AB  - 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-Asberg 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 > or =50% compared to baseline, was achieved by 6 out of 
      11 subjects, 4 of whom were considered remitters (HAM-D endpoint score < or = 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.
FAU - Dell'Osso, Bernardo
AU  - Dell'Osso B
AD  - Department of Psychiatry, University of Milan, Fondazione IRCCS Ospedale Maggiore 
      Policlinico, Mangiagalli e Regina Elena. Milano, Italy. 
      bernardo.dellosso@policlinico.mi.it
FAU - Mundo, Emanuela
AU  - Mundo E
FAU - D'Urso, Nazario
AU  - D'Urso N
FAU - Pozzoli, Sara
AU  - Pozzoli S
FAU - Buoli, Massimiliano
AU  - Buoli M
FAU - Ciabatti, MariaTeresa
AU  - Ciabatti M
FAU - Rosanova, Mario
AU  - Rosanova M
FAU - Massimini, Marcello
AU  - Massimini M
FAU - Bellina, Valentina
AU  - Bellina V
FAU - Mariotti, Maurizio
AU  - Mariotti M
FAU - Altamura, A Carlo
AU  - Altamura AC
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Denmark
TA  - Bipolar Disord
JT  - Bipolar disorders
JID - 100883596
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Analysis of Variance
MH  - Bipolar Disorder/physiopathology/*therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
MH  - Prefrontal Cortex/physiology
MH  - Psychiatric Status Rating Scales
MH  - *Transcranial Magnetic Stimulation
MH  - Young Adult
EDAT- 2009/01/13 09:00
MHDA- 2009/04/07 09:00
CRDT- 2009/01/13 09:00
PHST- 2009/01/13 09:00 [entrez]
PHST- 2009/01/13 09:00 [pubmed]
PHST- 2009/04/07 09:00 [medline]
AID - BDI651 [pii]
AID - 10.1111/j.1399-5618.2008.00651.x [doi]
PST - ppublish
SO  - Bipolar Disord. 2009 Feb;11(1):76-81. doi: 10.1111/j.1399-5618.2008.00651.x.