J Neurol Neurosurg Psychiatry 1999;67:113-115 ( July )

Short report

Right frontal lobe slow frequency repetitive transcranial magnetic stimulation (SF r-TMS) is an effective treatment for depression: a case-control pilot study of safety and efficacy Daniel L Menkes^a, Peter Bodnar^c, Roderick A Ballesteros^b, Michael R Swenson^a

^a Department of Neurology, University of Louisville, 500 South Presyon Street, HSC 113, Louisville, KY 40202, USA, ^b 60th MDOS/SGOMU, 101 Bodin Circle, Travis AFB, CA 94535, USA, ^c 249 Ballindine Drive, Vacaville, CA 95688, USA

Correspondence to: Dr D L Menkes, Department of Neurology, University of Louisville, 500 South Presyon Street, HSC 113, Louisville, KY 40202, USA

Received 17 July 1998 and in revised form 23 December 1998; Accepted 27 January 1999

Major depression may result from decreased left frontal lobe function with respect to the right. Fast frequency repetitive transcranial magnetic stimulation (FF r-TMS) excites the underlying cortex whereas slow frequency repetitive transcranial magnetic stimulation (SF r-TMS) causes cortical inhibition. Left frontal FF r-TMS attenuates major depression whereas the inhibitory effects of right frontal SF r-TMS are unknown. This study tested the hypothesis that right frontal SF r-TMS would treat depressed patients with minimal effect on controls.
  A psychiatrist administered the Beck depression inventory and Hamilton D depression rating scales to eight depressed patients and six controls before and after the treatment protocol. Eight sessions of 100 right frontal lobe SF r-TMS were given at motor threshold and 0.5 Hz over a 6 week period.   No adverse outcomes were noted in either group. A significant antidepressant effect was noted in depressed patients on the Beck and Hamilton D depression rating scales (p<0.05). No change on either scale was noted in the controls.   In conclusion right frontal lobe SF r-TMS is a safe, non-invasive treatment for major depression that deserves further investigation.


Keywords: transcranial magnetic stimulation; depression; slow frequency; right frontal lobe

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© 1999 by Journal of Neurology, Neurosurgery, and Psychiatry
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