@article{e13e5454e0e74f4ab19ea0f3822c260e,
title = "Cognitive-emotional reactivation during deep transcranial magnetic stimulation over the prefrontal cortex of depressive patients affects antidepressant outcome",
abstract = "Background: Transcranial magnetic stimulation (TMS) enables non-surgical activation of specific brain areas. TMS over the prefrontal cortex (PFC) is emerging as a significant tool that can augment or replace non/partially effective antidepressant medications. Deep TMS (DTMS) utilizes newly developed coils that enable effective stimulation of deeper cortical layers involved in the pathophysiology of depression. Objectives: We aimed to assess the H1-DTMS coil as an add-on to antidepressants in treating patients with major depression. We also intended to evaluate whether the antidepressant outcome of DTMS treatment is affected by a cognitive-emotional procedure performed during stimulation. Methods: 57 patients were enrolled in the study that included 4 weeks of daily 20 Hz stimulation sessions and additional 4 weekly sessions as a short maintenance phase. Two subgroups of patients received either positive or negative cognitive-emotional reactivation along with the stimulation sessions. Results: 21 of 46 patients (46%) who received at least 10 stimulation sessions achieved response (improvement of ≥ 50% in the Hamilton Depression Rating Scale (HDRS)) and 13 of them (28%) achieved remission (HDRS-24 ≤ 10) by the end of the daily treatment phase. Improvements were smaller in the negatively reactivated group and Beck Depression Inventory scores were not significantly improved in this group. Conclusions: DTMS over the PFC proved to be safe and effective in augmenting antidepressant medications. Negative cognitive-emotional reactivation can disrupt the therapeutic effect of DTMS. A large sham controlled study is required to further establish the effectiveness of DTMS as an augmentation treatment and the role of cognitive reactivation during stimulation.",
keywords = "Cognitive, Deep TMS, H-coil, Major depression, Mindstreams, PFC",
author = "Moshe Isserles and Oded Rosenberg and Pinchas Dannon and Yechiel Levkovitz and Moshe Kotler and Frederic Deutsch and Bernard Lerer and Abraham Zangen",
note = "Funding Information: We would like to thank Drs. Ely Simon and Glen Doniger from the NeuroTrax Corporation for letting us use the Mindstreams cognitive battery in this study. Dr. Zangen is an incumbent of the Joseph and Celia Reskin career development chair. This study was supported by the Rosenzweig-Coopersmith Fund and Brainsway Inc. Funding Information: Funding for this study was provided by Brainsway, Inc, a company that is interested in the development of deep TMS coils. Funding Information: Dr. Isserles receives financial support from Brainsway, Inc. which develops the H-coils. ",
year = "2011",
month = feb,
doi = "10.1016/j.jad.2010.06.038",
language = "אנגלית",
volume = "128",
pages = "235--242",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier B.V.",
number = "3",
}