ECT, rTMS, and deepTMS in pharmacoresistant drug-free patients with unipolar depression: a comparative review

Figures & data

Figure 1 Number of enrolled patients.

Abbreviations: ECT, electroconvulsion therapy; rTMS, transcranial magnetic stimulation; deepTMS, deep transcranial magnetic stimulation.

Table 1 Included studies

Study	Technique	Stimulation	Patients, n	Duration
Sackeim et al^Citation24	ECT	Right unilateral and bilateral; convulsive threshold or 2.5 times threshold	96	4 weeks
Rosa et al^Citation25	ECT	Right unilateral at a mean charge of 4.5 times the threshold. If there was no antidepressant response after 2 weeks, bilateral ECT was performed. At 1.5 times the threshold	15	4 weeks
Grunhaus et al^Citation26	ECT	Unilateral up to 2.5 times the threshold. If there was no antidepressant response after 2 weeks, bilateral ECT was performed	20	4 weeks
Dannon and Grunhaus^Citation27	ECT	Unilateral up to 2.5 times the threshold. If there was no antidepressant response after 2 weeks, bilateral ECT was performed	29	4 weeks
O’Reardon et al^Citation30	rTMS	10 Hz; left DLPFC; 120% of motor threshold	143	6 weeks
Berman et al^Citation31	rTMS	20 Hz; left DLPFC; 80% of motor threshold	10	2 weeks
Grunhaus et al^Citation26	rTMS	10 Hz; left DLPFC; 90% of motor threshold	20	4 weeks
Baeken et al^Citation32	rTMS	10 Hz; left DLPFC; 110% of motor threshold	18	2 weeks
Rosa et al^Citation25	rTMS	10 Hz; left DLPFC; 100% of motor threshold	20	4 weeks
Levkovitz et al^Citation13	DeepTMS	20 Hz; left and bilateral DLPFC; 110% and 120% of motor threshold	53	4 weeks
Rosenberg et al^Citation14	DeepTMS	20 Hz; left DLPFC; 120% of motor threshold	5	4 weeks

Abbreviations: ECT, electroconvulsion therapy; rTMS, transcranial magnetic stimulation; DLPFC, dorsolateral prefrontal cortex.

Figure 2 HDRS-24 % decrease in patients treated with ECT, rTMS, and deepTMS from baseline to the fourth week of treatment.

Abbreviations: HDRS, Hamilton Depression Rating Scale; ECT, electroconvulsion therapy; rTMS, transcranial magnetic stimulation; deepTMS, deep transcranial magnetic stimulation.

Figure 3 HDRS-24 % decrease in patients treated with ECT and deepTMS after 2 and 4 weeks of treatment.

Abbreviations: HDRS, Hamilton Depression Rating Scale; ECT, electroconvulsion therapy; deepTMS, deep transcranial magnetic stimulation.

Figure 4 Cognitive variations in patients treated with ECT and rTMS from T0 to T1 (2 weeks of treatment).

Abbreviations: ECT, electroconvulsion therapy; RBMT, Rivermead Behavioral Memory Test; rTMS, transcranial magnetic stimulation; WAIS, Weschler Adult Intelligence Scale; WAIS-R, Weschler Adult Intelligence Scale-Revised; WMS, Wechsler Memory Scale.

Figure 5 Cognitive variations in patients treated with ECT and rTMS from T0 to T2 (4 weeks of treatment).

Abbreviations: ECT, electroconvulsion therapy; RBMT, Rivermead Behavioral Memory Test; rTMS, transcranial magnetic stimulation; WAIS, Weschler Adult Intelligence Scale; WAIS-R, Weschler Adult Intelligence Scale-Revised; WMS, Wechsler Memory Scale.

Figure 6 Percentage of remitted patients.

Abbreviations: ECT, electroconvulsion therapy; rTMS, transcranial magnetic stimulation; deepTMS, deep transcranial magnetic stimulation.

Figure 7 Percentage of dropped-out patients.

Abbreviations: ECT, electroconvulsion therapy; rTMS, transcranial magnetic stimulation; deepTMS, deep transcranial magnetic stimulation.

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