|Low frequency right transcranial magnetic stimulation for major depressive disorder
This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database.
HAYES, Inc.. Low frequency right transcranial magnetic stimulation for major depressive disorder. Lansdale: HAYES, Inc.. Healthcare Technology Brief Publication. 2016
Major depressive disorder (MDD) is a leading cause of disability in the United States and in other developed countries. Approximately one-third of patients with nonpsychotic MDD may be treatmentresistant, based on failures of at least 2 trials of antidepressants.
Description of Technology: Low frequency repetitive transcranial magnetic stimulation (LFrTMS) is a noninvasive treatment that applies brief, repetitive magnetic pulses, to the right dorsolateral prefrontal cortex (DLPFC). Each train consists of a specific number of low-frequency (1 hertz) stimulations and are spaced by
intertrain intervals during which no stimulation is applied. Each session takes approximately 40 minutes. A full course of repetitive transcranial magetic stimulation (rTMS) usually involves 1 session a day, 5 days a week for 2 weeks. It is believed that the prefrontal cortex is differentially engaged in regulating mood. Specifically, the right hemisphere is thought to mediate negative mood while the left mediates positive mood. The rTMS as applied to the prefrontal cortex is purported to enhance or decrease cortical excitability depending on placement. Whereas high frequency repetitive transcranial magnetic stimulation (HFrTMS) is applied to the left DLPFC and is used to induce cortical excitability, proponents suggest that applying LFrTMS to the right DLPFC creates a suppressive effect and thereby produces antidepressant results.
Patient Population: LFrTMS is used to treat a number of disorders including, but not limited to, schizophrenia, obsessive compulsive disorder, and tinnitus. This health technology assessment is specifically focused on the
therapeutic use of LFrTMS for treatment-resistant MDD in adults.
Clinical Alternatives: Transcranial magnetic stimulation was initially developed as a physiologically similar but potentially more acceptable alternative to electroconvulsive therapy, which involves delivering electrical pulses to the brain via electrode pads positioned on the scalp above mood centers in the brain. Other clinical
alternative approaches to treatment-resistant MDD include vagus nerve stimulation, deep brain stimulation, magnetic seizure therapy (also called magnetic convulsion therapy), epidural cortical stimulation, and cranial electric (or electrotherapy) stimulation.
Subject indexing assigned by CRD
Depressive Disorder, Major; Humans; Prefrontal Cortex; Transcranial Magnetic Stimulation; Treatment Outcome
Country of organisation
An English language summary is available.
Address for correspondence
HAYES, Inc., 157 S. Broad Street, Suite 200, Lansdale, PA 19446, USA. Tel: 215 855 0615; Fax: 215 855 5218 Email: firstname.lastname@example.org
Date abstract record published