Treatment of patients with geriatric depression with repetitive transcranial magnetic stimulation.

Abstract

Repetitive transcranial magnetic stimulation (rTMS) has become a useful tool to treat different neuropsychiatric conditions such as depression, dementia and extrapyramidal syndromes insufficiently responding to conventional treatment. In this SHAM-controlled exploratory study safety, symptom improvement as well as changes in inflammation markers and neurotransmitter precursor amino acids availability were studied after a prefrontal cortex (PFC) stimulation using rTMS as add-on treatment in 29 patients with geriatric depression. Out of these, ten patients received SHAM treatment. Treatment was well tolerated, no serious adverse effects were observed. A clear improvement in symptoms of depression with a significant decrease in the HAMD-7 (U = 3.306, p = 0.001) was found by rTMS treatment. In parallel, serum phenylalanine dropped significantly (U = 2.340, p < 0.02), and there was a decline of tryptophan and of Phe/Tyr concentrations, both the effects, however, failed to reach the levels of statistical significance. In the patients who underwent SHAM treatment, no significant changes of HAMD-7 or the concentrations of any biomarker in the study could be found. In addition to the significant effect of rTMS on depression scores, these results point to a possible influence of rTMS on the enzyme phenylalanine hydroxylase (PAH), which plays a crucial role in the biosynthesis of neurotransmitter precursors related to geriatric depression.

• Authors: F Leblhuber, K Steiner, Dietmar Fuchs
• Journal: Journal of neural transmission (Vienna, Austria : 1996) (J Neural Transm (Vienna)) Vol. 126 Issue 8 Pg. 1105-1110 (08 2019) ISSN: 1435-1463 [Electronic] Austria
• PMID: 31250285 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Phenylalanine

Topics

• Aged
• Biomarkers (blood)
• Depressive Disorder, Treatment-Resistant (blood, therapy)
• Female
• Humans
• Male
• Phenylalanine (blood)
• Pilot Projects
• Prefrontal Cortex
• Psychiatric Status Rating Scales
• Transcranial Magnetic Stimulation
• Treatment Outcome