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Rapid Symptom Improvement in Major Depressive Disorder Using Accelerated Repetitive Transcranial Magnetic Stimulation

Clinical Psychopharmacology and Neuroscience 2021년 19권 1호 p.73 ~ 83
김수정, 손상준, 장미, 김병훈, 홍석주, 서리나, 최선우, 석정호, 노재성,
소속 상세정보
김수정 ( Kim Soo-Jeong ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Psychiatry
손상준 ( Son Sang-Joon ) - Ajou University School of Medicine Department of Psychiatry
장미 ( Jang Mi ) - National Center for Mental Health Department of Mental Health Services
김병훈 ( Kim Byung-Hoon ) - Yonsei University College of Medicine Institute of Behavioral Science in Medicine
홍석주 ( Hong Seok-Joo ) - Ajou University School of Medicine Department of Psychiatry
서리나 ( Seo Li-Na ) - Ajou University School of Medicine Department of Psychiatry
최선우 ( Choi Sun-Woo ) - Yonsei University College of Medicine Institute of Behavioral Science in Medicine
석정호 ( Seok Jeong-Ho ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Psychiatry
노재성 ( Noh Jai-Sung ) - Ajou University School of Medicine Department of Psychiatry

Abstract


Objective: Repetitive transcranial magnetic stimulation (rTMS) has contributed to increase in the remission rate for patients with major depressive disorder (MDD). However, current rTMS treatment is practically inconvenient because it requires daily treatment sessions for several weeks. Accelerated rTMS treatment is as efficient and safe for MDD patients as conventional rTMS.

Methods: Fifty-one patients with MDD participated in this study; they were randomized into accelerated rTMS (n = 21), conventional rTMS (n = 22), and sham-treatment (n = 8) groups. The accelerated and conventional rTMS groups received 15 sessions for 3 days and 3 weeks, respectively. The sham-treatment group received 15 sham rTMS sessions for 3 days. Primary outcome was assessed using self-report and clinician-rated Korean Quick Inventory of Depressive Symptomatology (KQIDS-SR and KQIDS-C, respectively). Adverse effects were monitored using the Frequency, Intensity, and Burden of Side Effects Rating scale. Changes in depressive symptoms were compared among the three groups using mixed model analyses.

Results: For the KQIDS-SR score, there was a significant main effect of “time” (F3,47 = 11.05, p < 0.001), but no effect of “group” (F2,47 = 2.04, p = 0.142), and a trend-level interaction effect of “group × time” (F6,47 = 2.26, p = 0.053). Improvement in depressive symptoms, based on the KQIDS-SR score 3 weeks after treatment, was more prominent in the accelerated rTMS group than in the sham-treatment group (p = 0.011). Tolerability was comparable among the three groups.

Conclusion: The accelerated rTMS treatment group showed rapid improvement of depressive symptoms compared with the sham-treatment and conventional rTMS treatment groups. Therefore, accelerated rTMS treatment could be a viable option for MDD, with improved accessibility.

키워드

Transcranial magnetic stimulation, repetitive; Major depressive disorder; Effectiveness, treatment; Safety; Accessibility, health services

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