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Psychiatry Investigation 2005;2(1):61-5.
Repeated Transcranial Magnetic Stimulation (rTMS) with Circular Coil for Patients with Treatment Resistant Depression: An Open Trial
Jeong-Ho Chae, MD, PhD;Won Kim, MD;Won-Myong Bahk, MD, PhD;Tae-Yun Jun, MD, PhD; and Kwang-Soo Kim, MD, PhD
Department of Psychiatry, The Catholic University of Korea, Seoul, Korea
Abstract

Of the two types of typical TMS coils, namely the figure of eight and circular coils, the former has been used more commonly in recent repeated transcranial magnetic stimulation (rTMS) trials in patients with depression. However, it is unclear whether one coil is superior to the other when used for clinical trials designed to assess their effectiveness as antidepressants, since positive results have been reported with both types. The present study is a pilot study designed to assess the effectiveness and safety of high frequency rTMS using a circular coil in Korean patients with refractory depression. Fifteen patients with depressive disorder were recruited into the study. rTMS was performed using an M-Cube stimulator with an oil-cooling circular coil on the left prefrontal cortex, and the stimulus parameters were; 20Hz, 2 seconds on, 28 seconds off, intensity at 100% of the patient's resting motor threshold. The rTMS treatment was administered for 20 minutes per day on weekdays over a 3 week period (for a total of 15 days of treatment). Thirteen subjects completed this 3 week trial. Over the course of the three weeks of rTMS treatment, all clinical variables, including the 21 item Hamilton Rating Scale for Depression, the Hamilton Anxiety Rating Scale and the Clinical Global Impression-Severity scale, were improved. The present study suggested that high frequency rTMS conducted at 20Hz with a circular coil has therapeutic potential for the treatment of refractory depression. Further evaluation of the therapeutic efficacy of rTMS should assess the importance of the various treatment parameters, and longer and medication free follow-up studies for the outcome of this treatment, along with a comparison between the different coil types, is also needed.

Key words   Transcranial magnetic stimulation, Depression, Treatment, Circular coil, Prefrontal cortex


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