Influencing Cognitive Deficit in Patients with Depressive Disorder by Means of Repetitive Transcranial Magnetic Stimulation (rTMS) Under Conditions of Single Blind Randomized Study

Czech version

Authors: H. Kučerová; R. Přikryl; P. Navrátilová; E. Češková; L. Ustohal
Authors‘ workplace: Psychiatrická klinika LF MU a FN, Brno přednostka prof. MUDr. E. Češková, CSc.
Published in: Čes. a slov. Psychiat., 104, 2008, No. 5, pp. 224-229.
Category: Original Article

Overview

We assessed 40 patients – men hospitalized at Department of Psychiatry, Medical Faculty and Faculty Hospital Brno. 22 patients were assessed as depressive episode (F32), 18 patients as recurrent depression disorder (F33) according to ICD 10th revision (research criteria). Patients were distributed into to two groups – rTMS (N=20) and antidepressants (N=20) treatment by random number generator. Into research group there were included only these patients, who subscribed informed consent and no contraindication to rTMS treatment were present. Different parameters of cognitive functions (memory, attention, verbal fluency, executive functions, etc.) were measured by comprehensive neuropsychological test battery, and psychopathology was assessed by HAMD and MADRS scales. During rTMS stimulation treatment we have found statistically significant improvement in psychomotor speed (TMT A), tolerance against perceptional and mental stress (CWT), verbal fluency task (VFT), and memory – in all indexes of WMS III. We have also found improvement in executive functions – in category of perseverative responses and perseverative errors. After treatment with antidepressants we have found statistically significant improvement in Stroop test (CWT), in Verbal Fluency Task (VFT) and in all indexes of WMS III too. In contrast to antidepressants rTMS stimulation treatment has been furthermore associated with the improvement in psychomotor speed an executive functions (perseverative responses and perseverative errors). Treatment with antidepressants did not change these parameters. The degree of depression change has not been correlated with the value of cognitive deficit dynamics before and after treatment setting in patients cured as with rTMS as with antidepressants. Concerning severity of psychopathology, results show that both ways of treatment settings, rTMS and antidepressants, are effective in the same way in the treatment of mild and modest depression. In conclusion we can say, that rTMS is more effective in the attenuation of cognitive deficit in patients suffered form depression than antidepressants treatment.

Key words:
rTMS, depression, cognitive deficit, psychopathology.

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Article was published in

Czech and Slovak Psychiatry

2008 Issue 5