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Priority Communication| Volume 46, ISSUE 12, P1603-1613, December 15, 1999

Frequency dependence of antidepressant response to left prefrontal repetitive transcranial magnetic stimulation (rTMS) as a function of baseline cerebral glucose metabolism

  • Timothy A Kimbrell
    Affiliations
    Biological Psychiatry Branch (TAK, JTL, RTD, MAF, JDR, ALD, MWW, BEB, AMS, EO, MSG, RMP), National Institute of Mental Health and Office of the Clinical Director, Bethesda, Maryland, USA

    Laboratory of Clinical Science (BDG), National Institute of Mental Health and Office of the Clinical Director, Bethesda, Maryland, USA
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  • John T Little
    Affiliations
    Biological Psychiatry Branch (TAK, JTL, RTD, MAF, JDR, ALD, MWW, BEB, AMS, EO, MSG, RMP), National Institute of Mental Health and Office of the Clinical Director, Bethesda, Maryland, USA

    National Institute of Neurological Disorders and Stroke (EMW), National Institutes of Health, Bethesda, Maryland, USA
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  • Robert T Dunn
    Affiliations
    Biological Psychiatry Branch (TAK, JTL, RTD, MAF, JDR, ALD, MWW, BEB, AMS, EO, MSG, RMP), National Institute of Mental Health and Office of the Clinical Director, Bethesda, Maryland, USA
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  • Mark A Frye
    Affiliations
    Biological Psychiatry Branch (TAK, JTL, RTD, MAF, JDR, ALD, MWW, BEB, AMS, EO, MSG, RMP), National Institute of Mental Health and Office of the Clinical Director, Bethesda, Maryland, USA
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  • Benjamin D Greenberg
    Affiliations
    Psychiatry Department, University of Arkansas, (TAK) Little Rock, USA
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  • Eric M Wassermann
    Affiliations
    Psychiatry Department, University of Pittsburgh, (JTL) Pittsburgh, Pennsylvania, USA
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  • Jennifer D Repella
    Affiliations
    Biological Psychiatry Branch (TAK, JTL, RTD, MAF, JDR, ALD, MWW, BEB, AMS, EO, MSG, RMP), National Institute of Mental Health and Office of the Clinical Director, Bethesda, Maryland, USA
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  • Aimee L Danielson
    Affiliations
    Biological Psychiatry Branch (TAK, JTL, RTD, MAF, JDR, ALD, MWW, BEB, AMS, EO, MSG, RMP), National Institute of Mental Health and Office of the Clinical Director, Bethesda, Maryland, USA
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  • Mark W Willis
    Affiliations
    Biological Psychiatry Branch (TAK, JTL, RTD, MAF, JDR, ALD, MWW, BEB, AMS, EO, MSG, RMP), National Institute of Mental Health and Office of the Clinical Director, Bethesda, Maryland, USA

    Psychiatry Department, University of Pittsburgh, (JTL) Pittsburgh, Pennsylvania, USA
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  • Brenda E Benson
    Affiliations
    Biological Psychiatry Branch (TAK, JTL, RTD, MAF, JDR, ALD, MWW, BEB, AMS, EO, MSG, RMP), National Institute of Mental Health and Office of the Clinical Director, Bethesda, Maryland, USA
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  • Andrew M Speer
    Affiliations
    Biological Psychiatry Branch (TAK, JTL, RTD, MAF, JDR, ALD, MWW, BEB, AMS, EO, MSG, RMP), National Institute of Mental Health and Office of the Clinical Director, Bethesda, Maryland, USA
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  • Elizabeth Osuch
    Affiliations
    Biological Psychiatry Branch (TAK, JTL, RTD, MAF, JDR, ALD, MWW, BEB, AMS, EO, MSG, RMP), National Institute of Mental Health and Office of the Clinical Director, Bethesda, Maryland, USA
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  • Mark S George
    Affiliations
    Biological Psychiatry Branch (TAK, JTL, RTD, MAF, JDR, ALD, MWW, BEB, AMS, EO, MSG, RMP), National Institute of Mental Health and Office of the Clinical Director, Bethesda, Maryland, USA

    Department of Psychiatry, Radiology & Neurology, Medical University of South Carolina, (MSG), Charleston, South CarolinaUSA
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  • Robert M Post
    Correspondence
    Address reprint requests to Robert M. Post, MD, BPB, NIMH, 10 Center Drive MSC-1272, Bethesda, MD 20892-1272
    Affiliations
    Biological Psychiatry Branch (TAK, JTL, RTD, MAF, JDR, ALD, MWW, BEB, AMS, EO, MSG, RMP), National Institute of Mental Health and Office of the Clinical Director, Bethesda, Maryland, USA
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      Abstract

      Background: Recent studies suggest that both high frequency (10–20 Hz) and low frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) have an antidepressant effect in some individuals. Electrophysiologic data indicate that high frequency rTMS enhances neuronal firing efficacy and that low frequency rTMS has the opposite effect.
      Methods: We investigated the antidepressant effects of 10 daily left prefrontal 1 Hz versus 20 Hz rTMS with the hypothesis that within a given subject, antidepressant response would differ by frequency and vary as a function of baseline cerebral glucose metabolism. After baseline PET scans utilizing [18F]-Fluorodeoxyglucose, thirteen subjects participated in a randomized crossover trial of 2 weeks of 20 Hz paired with 2 weeks 1 Hz or placebo rTMS.
      Results: We found a negative correlation between degree of antidepressant response after 1 Hz compared to 20 Hz rTMS (r = −0.797, p < .004). Additionally, better response to 20 Hz was associated with the degree of baseline hypometabolism, whereas response to 1 Hz rTMS tended to be associated with baseline hypermetabolism.
      Conclusions: These preliminary results suggest that antidepressant response to rTMS might vary as a function of stimulation frequency and may depend on pretreatment cerebral metabolism. Further studies combining rTMS and functional neuroimaging are needed.

      Keywords

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