Efficacy of adjunctive high frequency repetitive transcranial magnetic stimulation of left prefrontal cortex in depression: a randomized sham controlled study

J Affect Disord. 2011 Jan;128(1-2):153-9. doi: 10.1016/j.jad.2010.06.027. Epub 2010 Jul 10.


Objective: To examine the efficacy of adjunctive left prefrontal high-frequency rTMS treatment in depression patients as compared to sham stimulation.

Method: 45 right handed moderate to severe depression patients according to ICD-10 DCR criteria were randomized to receive daily sessions of active or sham rTMS (10Hz, 90% of resting MT, 20 trains, 6s duration, 1200 pulses/day) over the right dorsolateral prefrontal cortex for 10 days. Depression and psychosis was rated using Structured Interview Guide for the Hamilton Depression Rating Scale (SIGH-D) and Brief Psychiatric Rating Scale (BPRS) respectively before and after rTMS.

Result: For SIGH-D scores, repeated measures ANOVA showed a significant effect of treatment over time as shown by interaction effect (Pillai's Trace F [1/38] = 56.75, p<.001, η(2) = .60). For BPRS, repeated measures ANOVA showed a significant interaction effect of treatment over time (Pillai's Trace F [1/38] = 39.87, p<.001, η(2) = .51). In psychotic depression patients, repeated measures ANOVA showed a significant effect of treatment over time for SIGH-D scores (Pillai's Trace F [1/25] = 43.04, p<.001, η(2) = .63) and BPRS scores (Pillai's Trace F [1/25] = 42.17, p<.001, η(2) = .63).

Conclusion: High-frequency left prefrontal rTMS was well tolerated and found to be effective as add-on to standard pharmacotherapy in nonpsychotic as well as psychotic depression.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Depression / diagnosis
  • Depression / psychology*
  • Depression / therapy*
  • Female
  • Functional Laterality
  • Humans
  • International Classification of Diseases
  • Logistic Models
  • Male
  • Middle Aged
  • Prefrontal Cortex*
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Transcranial Magnetic Stimulation*
  • Treatment Outcome
  • Young Adult