Effectiveness of repetitive transcranial magnetic stimulation on symptoms of treatment resistant depression

Repetitive transcranial magnetic stimulation (rTMS) is increasingly used for treatment-resistant depression (TDD). In our study, we investigated the effectiveness of high frequency rTMS treatment in TDD patients. The study was a randomized controlled single-blind study, which was conducted between June-2019 and August-2020 with 52 participants, 26 of which were placebo. rTMS sessions were held once a day, for a total of 15 sessions over a 3-week period. The rTMS protocol was high frequency (10 hz) applied to the left dorsolateral prefrontal cortex (DLPFC), 120% of the motor threshold (MT), 3000 pulses/session. Hamilton Depression Rating Scale (HAM-D 17) and Montgomery Asberg Depression Rating Scale (MADRS) scales were used to assess response to treatment. A decrease of more than 50% in scale scores was considered as treatment response. As a result of the treatment, the decreases in scale scores were found to be significant in both groups (p=0,001 p=0,001). The decrease in the scale scores of the treatment group was significantly higher than the placebo group (p=0,008 p=0,003). Response rate to treatment was 65% in the treatment group and 19% in the placebo group. The remission rate was 30.8% in the treatment group and 19% in the placebo group. The participants tolerated the treatment well and there were no serious side effects. Our study has shown that high frequency rTMs application is an effective and safe treatment option for TDD patients. More clinical studies are needed for treatment optimization. Key Words: Dorsolateral Prefrontal Cortex, Treatment-Resistant Depression, Single-Blind Study