Repetitive transcranial magnetic stimulation (rTMS) therapy has been approved for treatment of depression by the FDA in 2008, and was included in APA Guidelines as published in October, 2010 issue of American Journal of Psychiatry. Although its efficacy is not as high as the efficacy of ECT, rTMS is safer in the treatment of depression in older patients. Especially the absence of common treatment side effects of ECT, such as confusion and memory problems, makes rTMS treatment more valuable in patients with high side effect risk.
This study was performed by the quantitative EEG (qEEG) monitoring before and after rTMS treatment. The aim was to examine the predictive value of qEEG as a biological indicator of response to rTMS treatment.
In Neuropsychiatry Istanbul Hospital, between dates of 2006-2010, rTMS had been applied to 1283 patients with a diagnosis of treatment-resistant depressive disorder. The patients discontinued the psychotropic medications 12 hours before the qEEG monitoring. qEEG records were taken just before the first and the last rTMS sessions. HAM-D 17 was performed before and after 15-20 (mean was 18) sessions of rTMS treatment.
The patients with a medical history of epilepsy were excluded. The cases with no history of seizures, but with suspicious epileptical abnormality in pre-treatment EEG were included with special medical caution. rTMS treatment was performed at left DLPFC, as 25 hz. and 1000 pulse, one session on each day, a total of 15-20 sessions, with Magstim Rapid.
The statistical analyses of the cases are ongoing. The initial results with remission and response rates will be presented. qEEG power spectrum changes and changes in the activation compared to normative data base in LORETA will be evaluated.