medigraphic.com
ISSN 0185-3325 (Print)
Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz

2013, Number 3

<< Back Next >>

Salud Mental 2013; 36 (3)

Análisis de fuentes del EEG en pacientes tratados con estimulación magnética transcraneal a 5 Hz como tratamiento antidepresivo

González-Olvera JJ, Ricardo-Garcell J, García-Anaya ML, Miranda-Terrés E, Reyes-Zamorano E, Armas-Castañeda G

Language: Spanish
References: 31
Page: 235-240
PDF size: 407.14 Kb.


ABSTRACT

Transcranial Magnetic Stimulation (rTMS) is a technique that allows noninvasive electrical stimulation of the cortex with few side effects. An antidepressant effect has been proposed when rTMS is delivered over prefrontal dorsolateral cortex (DLPFC) ≥5Hz. Quantitative EEG studies have shown increases in alpha and theta power bands as well as frontal interhemispheric asymmetries in most recordings from depressed patients. rTMS over left DLPFC at 5Hz involve a safer and more tolerable procedure, and its neurophysiological correlates has not been explored using EEG source analysis. The aim of this research was to study changes in EEG sources using VARTERA method in a group of patients with major depressive disorder (MDD) treated with 5Hz rTMS over left DLPFC as single or combined treatment with escitalopram.
Methods: 18 patients with DSM-IV MDD diagnosis without treatment for the current episode were included. Subjects were randomly assigned to one of two groups: A) rTMS+escitalopram 10mg, n=9; B) rTMS+placebo, n=9. Subjects received 15 sessions of rTMS on a daily basis. In order to compare changes in EEG sources two recordings were obtained, prior and after treatment. HDRS, BDI and HARD were used for clinical assessments.
Results: All patients of group A and eight patients of group B showed response to treatment (considered as a reduction of 50% in HDRS score). An increase in absolute power at 9.37Hz and 10.17Hz in temporal and postcentral gyrus on the left hemisphere was found in group B. Absolute power in those frequencies was decreased in the same regions for group A. In addition, an increased power in beta band frequencies was observed in both hemispheres for group A.
Conclusion: Increases in alpha band could be the hallmark of the 5Hz rTMS, but it could be reduced by escitalopram. Besides, increases observed in beta band for group A could be related to escitalopram effect.


REFERENCES

  1. Couturier JL. Safety and efficacy of repetitive transcranial magnetic stimulation in the treatment of depression: a critical appraisal of the last 10 years. J Psychiatry Neurosc 2005;30:83–90.

  2. Fregni F, Pascual-Leone A. A review of the safety of repetitive transcranial magnetic stimulation as a clinical treatment for depression. J Psychiatry Neurosc 2008;30(1):434.

  3. Gross M, Nakamura L, Pascual-Leone A, Fregni F. Has repetitive transcranial magnetic stimulation (rTMS) treatment for depression improved? A systematic review and meta-analysis comparing the recent vs. the earlier rTMS studies. Acta Psychiatr Scand 2007;116:165-173.

  4. Brunoni AR, Lopes M, Kaptchuk TJ, Fregni F. Placebo Response of Non-Pharmacological and Pharmacological Trials in Major Depression: A Systematic Review and Meta-Analysis. PLoS ONE 2009;4:10.

  5. Kozel FA, George MS. Meta-analysis of left prefrontal repetitive transcranial magnetic stimulation (rTMS) to treat depression. J Psychiatr Pract 2002;8:270–275.

  6. Herrmann LL, Ebmeier KP. Factors modifying the efficacy of transcranial magnetic stimulation in the treatment of depression: a review. J Clin Psychiatry 2006;67:1870–1876.

  7. Brunelin J, Poulet E, Boeuve C, Zeroug-Vial H et al. Efficacy of repetitive transcranial magnetic stimulation (rTMS) in major depression: a review. Encephale 2011;33:126–134.

  8. Schutter DJLG. Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis. Psychol Med 2009;39(1):65–75.

  9. Wassermann EM. Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5-7, 1996. Electroencephalogr Clin Neurophysiol 1998;108:1–16.

  10. George MS, Nahas Z, Molloy M et al. A controlled trial of daily left prefrontal cortex TMS for treating depression 2000. Biol Psychiatry. 2000;48:962-970.

  11. García-Anaya M, González-Olvera J, Ricardo-Garcell J et al. Clinical and electrophysiological effect of right and left repetitive transcranial magnetic stimulation in patients with major depressive disorder. Salud Mental 2011;34:291–299.

  12. Hughes JR, John ER. Conventional and quantitative electroencephalography in psychiatry. J Neuropsychiatry Clin Neurosci 1999;11:190–208.

  13. Prichep LS, John ER. QEEG profiles of psychiatric disorders. Brain Topogr 1992;4:249–257.

  14. Knott VJ, Telner JI, Lapierre YD, Browne M et al. Quantitative EEG in the prediction of antidepressant response to imipramine. J Affect Disord 1996;39:175-184.

  15. Knott V, Mahoney C, Kennedy S, Evans K. EEG Power, Frequency, Asymmetry and Coherence in Male Depression. Psych Res 2001;106:123–140.

  16. Monakhov K, Perris C. Neurophysiological correlates of depressive symptomatology. Neuropsychobiology 1980;6:268–279.

  17. Nieber D, Schlegel S. Relationships between psychomotor retardation and EEG power spectrum in major depression. Neuropsychobiology 1992;25(1):20–23.

  18. Nyström C, Matousek M, Hällström T. Relationships between EEG and clinical characteristics in major depressive disorder. Acta Psychiatr Scand 1986;73:390–394.

  19. Bosch-Bayard J, Valdés-Sosa P, Virues-Alba T et al. 3D statistical parametric mapping of EEG source spectra by means of variable resolution electromagnetic tomography (VARETA). Clin EEG Neurosci 2001;32:47–61.

  20. Hughes JR, John ER. Conventional and quantitative electroencephalography in psychiatry. J Neuropsychiatry Clin Neurosci 1999;11:190–208.

  21. Saletu B, Anderer P, Saletu-Zyhlarz GM. EEG topography and tomography (LORETA) in diagnosis and pharmacotherapy of depression. Clin EEG Neurosci 2010;41:203–210.

  22. First MB, Spitzer RL, Gibbon M, Williams JB. Entrevista clínica estructurada para los trastornos del eje I del DSM-IV: SCID-I: versión clínica. España: Elsevier; 1999.

  23. Ramos-Brieva JA, Cordero-Villafafila A. A new validation of the Hamilton Rating Scale for Depression. J Psychiatr Res 1988;22:21–28.

  24. Lobo A, Chamorro L, Luque A, Dal-Ré R et al. Validation of the Spanish versions of the Montgomery-Asberg depression and Hamilton anxiety rating scales. Med Clin (Barc) 2002;118:493–499.

  25. Beck AT, Ward CH, Mendelson M, Mock J et al. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-571.

  26. Keel JC, Smith MJ, Wassermann EM. A safety screening questionnaire for transcranial magnetic stimulation. Clin Neurophysiol 2001;112:720.

  27. Fitzgerald PB, Daskalakis ZJ. A practical guide to the use of repetitive transcranial magnetic stimulation in the treatment of depression. Brain Stimul 2012;5:287–296.

  28. Nahas Z, Bohning DE, Molloy MA, Oustz JA et al. Safety and feasibility of repetitive transcranial magnetic stimulation in the treatment of anxious depression in pregnancy: a case report. J Clin Psychiatry 1999;60:50–52.

  29. O’Reardon JP, Solvason HB, Janicak PG, et al. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiat 2007;67:1208–1216.

  30. Veniero D, Brignani D, Thut G, Miniussi C. Alpha-generation as basic response-signature to transcranial magnetic stimulation (TMS) targeting the human resting motor cortex: A TMS/EEG co-registration study. Psychophysiology 2011;48:1381–1389.

  31. Fuggetta G, Pavone EF, Fiaschi A, Manganotti P. Acute modulation of cortical oscillatory activities during short trains of high-frequency repetitive transcranial magnetic stimulation of the human motor cortex: a combined EEG and TMS study. Hum Brain Mapp 2008;29:1–13.




2020     |     www.medigraphic.com