High frequency repetitive transcranial magnetic stimulation treatment for major depression: dissociated effects on psychopathology and neurocognition

摘要

Objective: This open-label pilot study explored the potential effects of High frequency repetitive transcranial magnetic stimulation (HF-rTMS) on two neurocognitive domains (decision-making and impulse control) in adult patients diagnosed with Major Depressive Disorder (MDD).Method: Subjects with a diagnosis of MDD (n=24) underwent HF-rTMS targeted at the left dorsolateral prefrontal cortex (lDLPFC) over the course of two weeks. Longitudinal changes in psychopathology were assessed by applying the Clinician-Administered Quick Inventory of Depressive Symptomatology (QIDS-C), the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR), and the Beck Anxiety Inventory (BAI) at baseline and after treatment completion; decision-making was assessed using the Iowa Gambling Task, the Balloon Analog Risk Task and the Game of Dice Task; impulse control was assessed using the Stroop Color-Word Task, the Continuous Performance Task and the Stop-Signal Task. The neurocognitive assessment was done at the same time-points as the psychopathology assessment.Results: Depression and anxiety scores improved significantly between baseline and end of treatment. However, none of the decision-making or impulse control variables of interest changed significantly across time. Moreover, there was no significant correlation between change in symptomatology and decision-making or impulse control.Conclusion: These preliminary findings suggest that HF-rTMS applied to the lDLPFC does not influence performance on decision-making or impulse control neurocognitive tasks in patients with MDD despite a significant reduction in depressive and anxious symptoms. Further studies with sham-controlled designs are warranted.