Resting motor threshold changes and clinical response to prefrontal repetitive transcranial magnetic stimulation in depressed patients

Authors

  • Jean-Baptiste Pretalli PhD,

    1. Department of Clinical Psychiatry
    2. EA 481 Neuroscience, IFR 133 University of Franche-Comté, Besançon, France
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  • Magali Nicolier PhD,

    1. Department of Clinical Psychiatry
    2. Clinical Investigation Centre CIC-IT 808 INSERM, University Hospital of Besançon
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  • Gilles Chopard MSc,

    1. Department of Clinical Psychiatry
    2. EA 481 Neuroscience, IFR 133 University of Franche-Comté, Besançon, France
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  • Pierre Vandel MD, PhD,

    1. Department of Clinical Psychiatry
    2. Clinical Investigation Centre CIC-IT 808 INSERM, University Hospital of Besançon
    3. EA 481 Neuroscience, IFR 133 University of Franche-Comté, Besançon, France
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  • Grégory Tio BSc,

    1. Department of Clinical Psychiatry
    2. Clinical Investigation Centre CIC-IT 808 INSERM, University Hospital of Besançon
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  • Julie Monnin PhD,

    1. Department of Clinical Psychiatry
    2. Clinical Investigation Centre CIC-IT 808 INSERM, University Hospital of Besançon
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  • Lionel Pazart MD, PhD,

    1. Clinical Investigation Centre CIC-IT 808 INSERM, University Hospital of Besançon
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  • Daniel Sechter MD,

    1. Department of Clinical Psychiatry
    2. EA 481 Neuroscience, IFR 133 University of Franche-Comté, Besançon, France
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  • Emmanuel Haffen MD, PhD

    Corresponding author
    1. Department of Clinical Psychiatry
    2. Clinical Investigation Centre CIC-IT 808 INSERM, University Hospital of Besançon
    3. EA 481 Neuroscience, IFR 133 University of Franche-Comté, Besançon, France
      Emmanuel Haffen, MD, PhD, Department of Clinical Psychiatry, University Hospital of Besançon, Service de Psychiatrie Adulte Pasteur, 2, Place Saint Jacques, 25030 Besançon cedex, France. Email: emmanuel.haffen@univ-fcomte.fr
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Emmanuel Haffen, MD, PhD, Department of Clinical Psychiatry, University Hospital of Besançon, Service de Psychiatrie Adulte Pasteur, 2, Place Saint Jacques, 25030 Besançon cedex, France. Email: emmanuel.haffen@univ-fcomte.fr

Abstract

Aims:  Several variables are able to influence the antidepressant effects of repetitive transcranial magnetic stimulation (rTMS), particularly the intensity of stimulation, which is generally expressed according to the resting motor threshold (RMT). The aim of our study was to investigate whether or not RMT changes during the treatment of resistant depression by rTMS and whether these fluctuations could alter treatment outcome.

Methods:  Seventy-five inpatients suffering from unipolar or bipolar treatment-resistant depression and who had been antidepressant-free or taking a stable antidepressant drug and a daily dose of benzodiazepine for at least a month received a left prefrontal rTMS session once a day for 10 days at 10 Hz and 95% RMT.

Results:  For the whole group, no significant fluctuation of RMT was observed between the first and the second week of rTMS treatment. However, RMT increased, decreased or remained constant throughout treatment depending on the patient. These RMT changes influenced the outcome of the 10 sessions concerning the severity of depressive and anxiety symptoms, measured by the Beck Depression Inventory and State Trait Anxiety, respectively.

Conclusions:  Our results justify calculating RMT regularly, and suggest that its variations play a role in treatment outcome.

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