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Nordic Journal of Psychiatry Volume 72, 2018 - Issue 8
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Original Article

Bifrontal active and sham rTMS in treatment-resistant unipolar major depression

Minna Valkonen-KorhonenDepartment of Psychiatry, Kuopio University Hospital, Kuopio, Finland; ;Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland; Correspondence[email protected]
,
Hanna LeinolaDepartment of Psychiatry, Kuopio University Hospital, Kuopio, Finland;
,
Mervi KönönenInstitute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland; ;Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland;
,
Eini NiskanenDepartment of Applied Physics, University of Eastern Finland, Kuopio, Finland;
,
Maija PurhonenDepartment of Psychiatry, Kuopio University Hospital, Kuopio, Finland; ;Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland;
,
Maarit PakarinenDepartment of Psychiatry, Kuopio University Hospital, Kuopio, Finland; ;Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland;
,
Anu RuusunenDepartment of Psychiatry, Kuopio University Hospital, Kuopio, Finland; ;Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland; ;Food and Mood Centre/IMPACT SRC School of Medicine, Deakin University, Geelong, Australia;
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Soili M. LehtoDepartment of Psychiatry, Kuopio University Hospital, Kuopio, Finland; ;Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland; ;Department of Psychology and Logopedics Faculty of Medicine, University of Helsinki, Helsinki, Finland;
,
Esa MervaalaInstitute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland; ;Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland; ;Institute of Clinical Medicine/Clinical Neurophysiology, University of Eastern Finland, Kuopio, Finland;
,
Kirsi HonkalampiSchool of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland;
,
Heli Koivumaa-HonkanenDepartment of Psychiatry, Kuopio University Hospital, Kuopio, Finland; ;Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland; ;Departments of Psychiatry: North Karelia Central Hospital, Joensuu, Finland; ;SOTE, Iisalmi, Finland; ;South-Savonia Hospital District, Mikkeli, Finland; ;Lapland Hospital District, Rovaniemi, Finland
&
Heimo ViinamäkiDepartment of Psychiatry, Kuopio University Hospital, Kuopio, Finland; ;Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland;
show all
Pages 586-592 | Received 01 Aug 2017, Accepted 08 Jul 2018, Published online: 23 Oct 2018
 
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Abstract

Background and aim: Prevention of the recurrence of major depression and its residual symptoms requires effective treatment. Our aim was to study the effects of bifrontal active rTMS controlled by sham rTMS in treatment-resistant unipolar major depressive disorder (MDD).

Methods: Thirty-seven patients with treatment-resistant MDD were randomized into two groups. One group received a total of 30 sessions of active bifrontal rTMS (10 Hz rTMS on left dorsolateral prefrontal cortex (DLPFC) and 1 Hz rTMS on right DLPFC) and the other group received bilateral sham rTMS on five days a week for six weeks.

Results: Depressive symptoms significantly improved in both the groups, but without a significant group difference. Furthermore, patients with psychotic depression improved similarly to those with moderate or severe depression.

Conclusions: The results of present study indicate a large sham effect of stimulation treatment. The intensive structured treatment protocol may explain the positive outcome in both the groups. It is important to recognize, appreciate, and utilize placebo effects as a significant means of rehabilitation in psychiatric care.

Disclosure statement

No potential conflict of interest was reported by the authors.

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