Efficacy of high frequency (rapid) suprathreshold repetitive transcranial magnetic stimulation of right prefrontal cortex in bipolar mania: A randomized sham controlled study
Volume 117, Issue 3, Pages 146-150 (October 2009)
Samir Kumar Praharaja, Daya Rama, Manu Arorab
Received 26 September 2008; received in revised form 30 December 2008; accepted 31 December 2008.
Abstract
Objective
To examine the efficacy of adjunctive right prefrontal high-frequency suprathreshold rTMS treatment in bipolar affective disorder, mania patients as compared to sham stimulation.
Method
41 right handed bipolar mania patients were randomized to receive daily sessions of active or sham rTMS (20 Hz, 110% of MT, 20 trains, 10 s intertrain interval) over the right dorsolateral prefrontal cortex for 10 days. Mania was rated using Young Mania Rating Scale (YMRS) and Clinical Global Impression (CGI) at baseline, and after 5th and 10th rTMS.
Result
For YMRS scores, repeated measures ANOVA showed a significant effect of treatment over time as shown by interaction effect (F = 12.95, df = 1.51/58.94, p < 0.001, Greenhouse-Geisser corrected). For CGI-S, repeated measures ANOVA showed a significant interaction effect of treatment over time (F = 5.34, df = 1.36/53.01, p = 0.016, Greenhouse-Geisser corrected).
Conclusion
High-frequency supra-threshold right prefrontal rTMS in bipolar, mania patients was well tolerated and found to be effective as add-on to standard pharmacotherapy.
Keywords: Bipolar affective disorder, Mania, rTMS
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