Data di Pubblicazione:
2014
Citazione:
RTMS in resistant mixed states: An exploratory study / S. Pallanti, G. Grassi, S. Antonini, L. Quercioli, E. Salvadori, E. Hollander. - In: JOURNAL OF AFFECTIVE DISORDERS. - ISSN 0165-0327. - 157:(2014), pp. 66-71. [10.1016/j.jad.2013.12.024]
Abstract:
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) has shown
efficacy in resistant unipolar depression, but its efficacy in bipolar disorders
has not yet been extensively investigated. Mixed episodes are reported in up to
40% of acute bipolar admissions and are associated with severe psychopathology,
comorbidity, high risk of suicide and poor treatment response. Right
low-frequency rTMS (LF-rTMS) as an augmentation treatment might be effective for
mixed states.
METHODS: Forty patients were treated during a 4-week period with a mood
stabilizer and subsequent rTMS (low frequency stimulation - 1Hz - applied to the
right Dorso-Lateral Prefrontal Cortex (DLPFC)) as add-on treatment for 3 weeks.
Response to LF-rTMS was assessed by the Hamilton Depression Rating Scale (HAM-D),
the Young Mania Rating Scale (YMRS) and the Clinical Global Impressions-Bipolar
Version (CGIBP) subscales. ANOVA with repeated measures performed on HAM-D, YMRS
and CGI-BP subscales "change from the preceding phase" and "severity of illness"
showed a statistically significant time effect from the baseline to the endpoint.
RESULTS: For the HAM-D there was a 46.6% responder rate, of which 28.6% was
remitted, while for the YMRS there was a 15% responder rate, all of which was
remitted.
LIMITATIONS: The open label-design of our study and the lack of a sham-controlled
group represent a methodological limitation.
CONCLUSIONS: The results suggest that LF-rTMS on the right DLFC might be a
potential augmentation strategy in the treatment of both depressive and manic
symptoms in mixed states.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
rTMS; Mixed states; Bipolar disorder; Low frequency
Elenco autori:
S. Pallanti, G. Grassi, S. Antonini, L. Quercioli, E. Salvadori, E. Hollander
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