Journal: Brain Stimulation (2016)
Authors: A Tendler, E Sisko, M DeLuca, L DeLuca, N Rodriguez, Sky Corbett-Methot, J Sutton-DeBord
Background:
The efficacy of deep transcranial magnetic stimulation (dTMS) for people with psychotic depression or schizoaffective disorder in the depressive phase is unknown.
Objective:
To determine the efficacy of dTMS with H1 coil in patients with schizophrenia and schizoaffective disorder depressive phase with or without psychosis.
Methods:
This is a retrospective chart review of five patients – four with Schizoaffective disorder and one with Schizophrenia. Three of the five patients were also psychotic, receiving dTMS for depression. dTMS was administered using the H1 coil to the left dorsolateral prefrontal cortex (LDPFC) at 18 Hz, 120% motor threshold (MT) for 1980 to 6012 total pulses. Patients remained on their psychotropics during dTMS. The Clinical Global Impression (CGI) was the primary outcome measure. Additional outcome measures included Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Patient Health Questionnaire (PHQ), and Positive and Negative Syndrome Scale (PANSS).
Results:
Two patients responded and three patients remitted in their depression. Two of the three patients with active psychosis had resolution of their psychosis when pulses were increased to 4024 and 6012 respectively after having failed 1980 pulses.
Conclusions:
dTMS with the H1 coil is efficacious for treatment of schizoaffective disorder in the depressive phase at 4024–6012 pulses per day. Further investigation is warranted to evaluate the efficacy of higher dose dTMS in patients with psychotic depression.
Full Publication: Deep transcranial magnetic stimulation for schizoaffective depressive phase – Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation
