Psychiatry Investig.  2019 Oct;16(10):745-750. 10.30773/pi.2019.07.17.3.

Evaluation of Transcranial Magnetic Stimulation Efficiency in Major Depressive Disorder Patients: A Magnetic Resonance Spectroscopy Study

Affiliations
  • 1Department of Radiology, Inonu University, Malatya, Turkey. drfatiherbay@hotmail.com
  • 2Department of Psychiatry, Inonu University, Malatya, Turkey.

Abstract


OBJECTIVE
Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder (MDD). This study evaluated the antidepressant effect of rTMS and examined how it affected N-asetyl aspartate (NAA), choline (Cho), creatine (Cr), lactate (Lac), myoinositol (mIns), glutamate (Glu), glutathione (GSH), and glutamine (Gln) metabolite levels in the left dorsolateral prefrontal cortex (DLPFC) of MDD patients who were not receiving antidepressant medication.
METHODS
In total, 18 patients (10 female, 8 male) were evaluated. Each patient underwent H magnetic resonance spectroscopy (H-MRS) before and within 3 days of completion of TMS therapy. All patients completed 20 sessions of rTMS directed at the left DLPFC over a 2-week period. The Hamilton Depression Scale (HAMD) scores of patients were calculated, and their responses to treatment were assessed within 1-3 days of completion of TMS.
RESULTS
We found statistically significant differences in HAMD scores before and after rTMS. Moreover, the peak metabolite ratios of NAA/Cr, GSH/Cr, and Gln/Cr were significantly higher after rTMS compared to those before rTMS.
CONCLUSION
Increased understanding of the mechanism of action of TMS will improve its application and may stimulate development of new-generation therapeutic agents.

Keyword

Transcranial magnetic stimulation; Depression; Magnetic resonance spectroscopy; Brain metabolites

MeSH Terms

Aspartic Acid
Choline
Creatine
Depression
Depressive Disorder, Major*
Female
Glutamic Acid
Glutamine
Glutathione
Humans
Inositol
Lactic Acid
Magnetic Resonance Spectroscopy*
Prefrontal Cortex
Transcranial Magnetic Stimulation*
Aspartic Acid
Choline
Creatine
Glutamic Acid
Glutamine
Glutathione
Inositol
Lactic Acid
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