Optimierung der repetitiven transkraniellen Magnetstimulation als Behandlung von Depressionen

Zusammenfassung

Die rTMS gilt derzeit als mögliche Therapieoption für depressive Patienten, welche auf andere antidepressive Behandlungsverfahren nicht oder nur unzulänglich ansprechen. Die Datenlage zur Effektivität spricht insgesamt für eine moderate antidepressive Wirksamkeit der rTMS, allerdings ist die klinische Bedeutung der beobachteten Effekte eher gering, sodass Studien zur Optimierung der Effektivität von Nöten sind. In der Berliner Prädiktor Studie wurden mit der rTMS des linken DLPFC über einen Zeitraum von zwei Wochen 70 depressive Patienten behandelt, von denen 21% respondierten. Da insbesondere Einsicht in Veränderungen der individuellen klinischen Symptomcluster gewonnen werden sollte, wurden fünf Cluster im Verlauf analysiert. Durch regressionsanalytische Methoden konnte gezeigt werden, dass neben generellen Prädiktoren wie eine kurze Episodendauer und ein geringes Maß an Therapieresistenz, besonders motorische Retardierung und Schlafstörungen klinische Prädiktoren für ein Ansprechen auf rTMS sind.

Summary

rTMS is considered to be a putative treatment option for those depressive patients being refractory or intolerant to other antidepressant treatment forms. Overall, published studies show a significant reduction in depressive symptomatology due to rTMS, but the clinical significance of the therapeutic changes were only modest. Therefore, studies to optimize the efficacy of rTMS are necessary. In the Berlin Predictor Study rTMS treatment of the left dorsolateral prefrontal cortex was performed in 70 patients of whom 21% showed an antidepressant response. Since individual clinical symptom clusters were of special interest, five clusters are analyzed during course of the treatment. By usinga logistic regression model it could be shown that beside general predictors like short duration of episode and low level of therapy resistance, especially motor retardation and sleep disturbances are clinical predictors fora response to rTMS.

Schlüsselwörter

Repetitive transkranielle Magnetstimulation (rTMS) - Depression - Prädiktoren für Response

Keywords

Repetitive transcranial magnetic stimulation (rTMS) - major depressive disorder - response prediction

• Literatur

• 1 Aarre TF, Dahl AA, Johansen JB, Kjonniksen I, Neckelmann D. Efficacy of repetitive transcranial magnetic stimulation in depression: a review of the evidence. Nord J Psychiatry 2003; 57: 227-32.
• 2 American Psychiatric Association. Task Force on DSM IV. Diagnostic and Statistical Manual of mental disorders—Text Revision (DSM IV-TR).
• 3 Bajbouj M, Heuser I. Vagus nerve stimulation, repetitive transcranial magnetic stimulation, and electroconvulsive therapy in the treatment of depressive disorders. Nervenarzt 2005; 76: 28-35.
• 4 Bajbouj M, Brakemeier EL, Schubert F, Lang UE, Neu P, Schindowski C, Danker-Hopfe H. Repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex and cortical excitability in patients with major depressive disorder. Exp Neurol. 2005 September 26..
• 5 Ballenger JC. et al. Consensus statement on the primary care management of depression from the International Consensus Group on Depression and Anxiety. J Clin Psychiatry 1999; 60 (Suppl. 07) 54-61.
• 6 Barker AT, Jalinous R, Freeston IL. Non-invasive magnetic stimulation of human motor cortex. Lancet 1985; 01: 1106-7.
• 7 Bauer M, Whybrow PC, Angst J, Versiani M, Moller HJ. World Federation of Societies of Biological Psychiatry (WFSBF) Task Force on Treatment Guidelines for Unipolar Depressive Disorders. World J Biol Psychiatry 2002; 03: 69-86.
• 8 Beck AT, Ward CH, Mendelson M, Mock J, Erbauch J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 04: 561-71.
• 9 Berman RM, Narasimhan M, Sanacora G. et al. A randomized clinical trial of repetitive transcranial magnetic stimulation in the treatment of major depression. Biol Psychiatry 2000; 47: 332-7.
• 10 Bschor T, Canata B, Muller-Oerlinghausen B, Bauer M. Predictors of response to lithium augmentation in tricyclic antidepressant-resistant depression. J Affect Disord 2001; 64: 261-5.
• 11 Buchan H, Johnstone E, McPherson K, Palmer RL, Crow TJ, Brandon S. Who benefits from electroconvulsive therapy? Combined results of the Leicester and Northwick Park trials. Br J Psychiatry 1992; 160: 355-9.
• 12 Burt T, Lisanby SH, Sackeim HA. Neuropsychiatric applications of transcranial magnetic stimulation: a meta analysis. Int J Neuropsychopharmacol 2002; 05: 73-103.
• 13 Chistyakov AV, Kaplan B, Rubichek O, Kreinin I, Koren D, Feinsod M, Klein E. Antidepressant effects of different schedules of repetitive transcranial magnetic stimulation vs. clomipramine in patients with major depression: relationship to changes in cortical excitability. Int J Neuropsychopharmacol 2005; 08: 223-33.
• 14 Conca A, Swoboda E, Konig P, Koppi S, Beraus W, Kunz A, Fritzsche H, Weiss P. Clinical impacts of single transcranial magnetic stimulation (sTMS) as an add-on therapy in severely depressed patients under SSRI treatment. Hum Psychopharmacol 2000; 15: 429-38.
• 15 Couturier JL. Efficacy of rapid-rate repetitive transcranial magnetic stimulation in the treatment of depression: a systematic review and meta-analysis. J Psychiatry Neurosci 2005; 30: 83-90.
• 16 Crevits L, Van den AD, Audenaert K, Goethals M, Dierick M. Effect of repetitive transcranial magnetic stimulation on saccades in depression:a pilot study. Psychiatry Res 2005; 13: 113-9.
• 17 de Vreede I, Burger H, van Vliet I. Prediction of response to ECT with routinely collected data in major depression. J Affect Disord 2005; 86: 323-7.
• 18 Dombrovski AY, Mulsant BH, Haskett RF, Prudic J, Begley AE, Sackeim HA. Predictors of Remission After Electroconvulsive Therapy in Unipolar Major Depression. J Clin Psychiatry 2005; 66: 1043-9.
• 19 Eschweiler GW. Prädiktoren für die Wirksamkeit der repetitiven transkraniellen Magnetstimulation. In: Eschweiler GW, Wild B, Bartels M. (Hrsg.). Elektromagnetische Therapien in der Psychiatrie. Darmstadt: Steinkopff Verlag; 2003: 232-40.
• 20 Eschweiler GW, Wegerer C, Schlotter W, Spandl C, Stevens A, Bartels M, Buchkremer G. Left prefrontal activation predicts therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) in major depression. Psychiatry Res 2000; 99 (03) 161-72.
• 21 Eschweiler GW, Plewnia C, Bartels M. Which patients with major depression benefit from prefrontal repetitive magnetic stimulation. Fortschr Neurol Psychiatr 2001; 69: 402-9.
• 22 Figiel GS. et al. The use of rapid-rate transcranial magnetic stimulation (rTMS) in refractory depressed patients. J Neuropsychiatry Clin Neurosci 1998; 10: 20-5.
• 23 Fitzgerald PB. et al. Motor cortical excitability and clinical response to rTMS in depression. J Affect Disord 2004; 82: 71-6.
• 24 George MS, Lisanby SH, Sackeim HA. Transcranial magnetic stimulation: applications in neuropsychiatry. Arch Gen Psychiatry 1999; 56 (04) 300-11.
• 25 George MS. et al. A controlled trial of daily left prefrontal cortex TMS for treating depression. Biol Psychiatry 2000; 48: 962-70.
• 26 Grunhaus L, Dannon PN, Schreiber S, Dolberg OH, Amiaz R, Ziv R, Lefkifker E. Repetitive transcranial magnetic stimulation is as effective as electroconvulsive therapy in the treatment of nondelusional major depressive disorder: an open study. Biol Psychiatry 2000; 47: 314-24.
• 27 Grunhaus L, Schreiber S, Dolberg OT, Polak D, Dannon PN. A randomized controlled comparison of electroconvulsive therapy and repetitive transcranial magnetic stimulation in severe and resistant nonpsychotic major depression. Biol Psychiatry 2003; 53: 324-31.
• 28 Hadzi-Pavlovic D, Hickie I, Brodaty H, Boyce P, Mitchell P, Wilhelm K, Parker G. Inter-rater reliability of a refined index of melancholia: the CORE system. J Affect Disord 1993; 27: 155-62.
• 29 Hamilton M. Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 1967; 06: 278-96.
• 30 Hansen PE, Videbech P, Clemmensen K, Sturlason R, Jensen HM, Vestergaard P. Repetitive transcranial magnetic stimulation as add-on antidepressant treatment. The applicability of the method in a clinical setting. Nord J Psychiatry 2004; 58: 455-7.
• 31 Hickie I, Mason C, Parker G, Brodaty H. Prediction of ECT response: validation of a refined signbased (CORE) system for defining melancholia. Br J Psychiatry 1996; 169: 68-74.
• 32 Hoflich G, Kasper S, Hufnagel S, Ruhrmann S, Moller H. Application of transcranial magnetic stimulation in treatment of drug-resistant major depression – a report of two cases. Human Psychopharmacol 1993; 08: 361-5.
• 33 Holtzheimer III PE, Russo J, Claypoole KH, RoyByrne P, Avery DH. Shorter duration of depressive episode may predict response to repetitive transcranial magnetic stimulation. Depress Anxiety 2004; 19: 24-30.
• 34 Huang CC, Su TP, Wei IH. Repetitive transcranial magnetic stimulation for treating medication-resistant depression in Taiwan: a preliminary study. J Chin Med Assoc 2005; 68: 210-5.
• 35 Janicak PG, Mask J, Trimakas KA, Gibbons R. ECT: an assessment of mental health professionals’ knowledge and attitudes. J Clin Psychiatry 1985; 466: 262-6.
• 36 Janicak PG. et al. Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression: preliminary results of a randomized trial. Biol Psychiatry 2002; 05: 659-67.
• 37 Januel D. et al. A double-blind sham controlled study of right prefrontal repetitive transcranial magnetic stimulation (rTMS): Therapeutic and cognitive effect in medication free unipolar depression during 4 weeks. Prog Neuropsychopharmacol Biol Psychiatry. 2005 October 19..
• 38 Keck ME, Welt T, Muller MB, Erhardt A, Ohl F, Toschi N, Holsboer F, Sillaber I. Repetitive transcranial magnetic stimulation increases the release of dopamine in the mesolimbic and mesostriatal system. Neuropharmacology 2002; 43: 101-9.
• 39 Keck Jr PE, Welge JA, Strakowski SM, Arnold LM, McElroy SL. Placebo effect in randomized, controlled maintenance studies of patients with bipolar disorder. Biol Psychiatry 2000; 47: 756-61.
• 40 Keller MB, Boland RJ. Implications of failing to achieve successful long-term maintenance treatment of recurrent unipolar major depression. Biol Psychiatry 1998; 44: 348-60.
• 41 Kimbrell TA. et al. Frequency dependence of antidepressant response to left prefrontal repetitive transcranial magnetic stimulation (rTMS) as a function of baseline cerebral glucose metabolism. Biol Psychiatry 1999; 46: 1603-13.
• 42 Koerselman F, Laman DM, van DH, van Duijn MA, Willems MA. A 3-month, follow-up, randomized, placebo-controlled study of repetitive transcranial magnetic stimulation in depression. J Clin Psychiatry 2004; 65: 1323-8.
• 43 Kozel FA, Nahas Z, DeBrux C, Molloy M, Lorberbaum JP, Bohning D, Risch SC, George MS. How coil-cortex distance relates to age, motor threshold, and antidepressant response to repetitive transcranial magnetic stimulation. J Neuropsychiatry Clin Neurosci 2000; 12: 376-84.
• 44 Kozel FA, George MS. Meta-analysis of left prefrontal repetitive transcranial magnetic stimulation (rTMS) to treat depression. J Psychiatr Pract 2002; 08: 270-5.
• 45 Li XM, Perry KW, Wong DT, Bymaster FP. Olanzapine increases in vivo dopamine and norepinephrine release in rat prefrontal cortex, nucleus accumbens and striatum. Psychopharmacology 1998; 136: 153-61.
• 46 Loo C, Mitchell P, Sachdev P, McDarmont B, Parker G, Gandevia S. Double-blind controlled investigation of transcranial magnetic stimulation for the treatment of resistant major depression. Am J Psychiatry 1999; 156: 946-8.
• 47 Loo CK, Mitchell PB. A review of the efficacy of transcranial magnetic stimulation (TMS) treatment for depression, and current and future strategies to optimize efficacy. J Affect Disord. 2005 September 1..
• 48 Manes F, Jorge R, Morcuende M, Yamada T, Paradiso S, Robinson RG. A controlled study of repetitive transcranial magnetic stimulation as a treatment of depression in the elderly. Int Psychogeriatr 2001; 13: 225-31.
• 49 Manes F, Jorge R, Morcuende M, Yamada T, Paradiso S, Robinson RG. A controlled study of repetitive transcranial magnetic stimulation as a treatment of depression in the elderly. Int Psychogeriatr 2001; 13: 225-31.
• 50 Martin JL, Barbanoj MJ, Schlaepfer TE, Thompson E, Perez V, Kulisevsky J. Repetitive transcranial magnetic stimulation for the treatment of depression. Systematic review and meta-analysis. Br J Psychiatry 2003; 182: 480-91.
• 51 Mayberg HS, Silva JA, Brannan SK, Tekell JL, Mahurin RK, McGinnis S, Jerabek PA. The functional neuroanatomy of the placebo effect. Am J Psychiatry 2002; 159: 728-37.
• 52 McNamara B, Ray JL, Arthurs OJ, Boniface S. Transcranial magnetic stimulation for depression and other psychiatric disorders. Psychol Med 2001; 31: 1141-6.
• 53 Milak MS, Parsey RV, Keilp J, Oquendo MA, Malone KM, Mann JJ. Neuroanatomic correlates of psychopathologic components of major depressive disorder. Arch Gen Psychiatry 2005; 62: 397-408.
• 54 Miniussi C, Bonato C, Bignotti S, Gazzoli A, Gennarelli M, Pasqualetti P, Tura GB, Ventriglia M, Rossini PM. Repetitive transcranial magnetic stimulation (rTMS) at high and low frequency: an efficacious therapy for major drug-resistant depression?. Clin Neurophysiol 2005; 116: 1062-71.
• 55 Mitchell PB, Schweitzer I, Burrows G, Johnson G, Polonowita A. Efficacy of venlafaxine and predictors of response in a prospective open-label study of patients with treatment-resistant major depression. J Clin Psychopharmacol 2000; 20: 483-7.
• 56 Mosimann UP, Schmitt W, Greenberg BD, Kosel M, Muri RM, Berkhoff M, Hess CW, Fisch HU, Schlaepfer TE. Repetitive transcranial magnetic stimulation: a putative add-on treatment for major depression in elderly patients. Psychiatry Res 2004; 126: 123-33.
• 57 Nahas Z. et al. Safety and benefits of distance-adjusted prefrontal transcranial magnetic stimulation in depressed patients 55–75 years of age: a pilot study. Depress Anxiety 2004; 19: 249-56.
• 58 Nelson JC, Mazure CM, Jatlow PI. Characteristics of desipramine-refractory depression. J Clin Psychiatry 1994; 55: 12-9.
• 59 Nobler MS, Devanand DP, Kim MK, Fitzsimons LM, Singer TM, Turret N, Sackeim HA, Roose SP. Fluoxetine treatment of dysthymia in the elderly. J Clin Psychiatry 1996; June; 57: 254-6.
• 60 Nobler MS, Sackeim HA. Elektrokrampftherapie. In: Helmchen H. (Hrsg.). Psychiatrie der Gegenwart. 5 Ed.. Berlin: Springer Verlag; 2000: 683-700.
• 61 O’Leary D, Gill D, Gregory S, Shawcross C. Which depressed patients respond to ECT? The Nottingham results. J Affect Disord 1995; 33: 245-50.
• 62 Padberg F, Zwanzger P, Thoma H, Kathmann N, Haag C, Greenberg BD, Hampel H, Moller HJ. Repetitive transcranial magnetic stimulation (rTMS) in pharmacotherapy-refractory major depression: comparative study of fast, slow and sham rTMS. Psychiatry Res 1999; 88: 163-71.
• 63 Padberg F. et al. Repetitive transcranial magnetic stimulation (rTMS) in major depression: relation between efficacy and stimulation intensity. Neuropsychopharmacology 2002; 27: 638-45.
• 64 Padberg F, Zwanzger P, Ella R, Rupprecht R, Moller HJ. Repetitive transcranial magnetic stimulation of the prefrontal cortex– the last resort in the treatment of depression?. MMW Fortschr Med 2004; 146 Spec No 2: 16-7.
• 65 Pascual-Leone A, Rubio B, Pallardo F, Catala MD. Rapid-rate transcranial magnetic stimulation of left dorsolateral prefrontal cortex in drug-resistant depression. Lancet 1996; 348: 233-7.
• 66 Post RM, Kimbrell T, Frye M, George M, McCann U, Little J, Dunn R, Li H, Weiss SRB. Implications of kindling and quenching for the possible frequency dependence of rTMS. CNS Spectrums 1997; 02: 54-60.
• 67 Post A, Keck ME. Transcranial magnetic stimulation as a therapeutic tool in psychiatry: what do we know about the neurobiological mechanisms?. J Psychiatr Res 2001; 35: 193-215.
• 68 Poulet E, Brunelin J, Boeuve C, Lerond J, D’Amato T, Dalery J, Saoud M. Repetitive transcranial magnetic stimulation does not potentiate antidepressant treatment. Eur Psychiatry 2004; 19: 382-3.
• 69 Pridmore S. Rapid transcranial magnetic stimulation and normalization of the dexamethasone suppression test. Psychiatry Clin Neurosci 1999; 53: 33-7.
• 70 Pridmore S. Substitution of rapid transcranial magnetic stimulation treatments for electroconvulsive therapy treatments ina course of electroconvulsive therapy. Depress Anxiety 2000; 12: 118-23.
• 71 Prudic J. et al. Resistance to antidepressant medications and short-term clinical response to ECT. Am J Psychiatry 1996; 153: 985-92.
• 72 Rossini D, Lucca A, Zanardi R, Magri L, Smeraldi E. Transcranial magnetic stimulation in treatment-resistant depressed patients:A double-blind, placebo-controlled trial. Psychiatry Res 2005; 137: 1-10.
• 73 Rumi DO, Gattaz WF, Rigonatti SP, Rosa MA, Fregni F, Rosa MO, Mansur C, Myczkowski ML, Moreno RA, Marcolin MA. Transcranial magnetic stimulation accelerates the antidepressant effect of amitriptyline in severe depression: a double-blind placebo-controlled study. Biol Psychiatry 2005; 57: 162-6.
• 74 Rush AJ, Carmody TJ, Haight BR, Rockett CB, Zisook S. Does pretreatment insomnia or anxiety predict acute response to bupropion SR?. Ann Clin Psychiatry 2005; 17: 1-9.
• 75 Sackeim HA. et al. Vagus nerve stimulation (VNS) for treatment-resistant depression: efficacy, side effects, and predictors of outcome. Neuropsychopharmacology 2001; 25: 713-28.
• 76 Sackeim HA. The definition and meaning of treatment-resistant depression. J Clin Psychiatry 2001; 62 (Suppl. 16) 10-7.
• 77 Schiffer F, Stinchfield Z, Pascual-Leone A. Prediction of clinical response to transcranial magnetic stimulation for depression by baseline lateral visual-field stimulation. Neuropsychiatry Neuropsychol Behav Neurol 2002; 15: 18-27.
• 78 Schlaepfer TE, Kosel M, Nemeroff CB. Efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of affective disorders. Neuropsychopharmacology 2003; 28: 201-5.
• 79 Schule C, Zwanzger P, Baghai T, Mikhaiel P, Thoma H, Moller HJ, Rupprecht R, Padberg F. Effects of antidepressant pharmacotherapy after repetitive transcranial magnetic stimulation in major depression: an open follow-up study. J Psychiatr Res 2003; 37: 145-53.
• 80 Schulze-Rauschenbach SC, Harms U, Schlaepfer TE, Maier W, Falkai P, Wagner M. Distinctive neurocognitive effects of repetitive transcranial magnetic stimulation and electroconvulsive therapy in major depression. Br J Psychiatry 2005; 186: 410-6.
• 81 Smesny S, Volz HP, Liepert J, Tauber R, Hochstetter A, Sauer H. Repetitive transcranial magnetic stimulation (rTMS) in the acute and long-term therapy of refractory depression--a case report. Nervenarzt 2001; 72: 734-8.
• 82 Sobin C, Prudic J, Devanand DP, Nobler MS, Sackeim HA. Who responds to electroconvulsive therapy? A comparison of effective and ineffective forms of treatment. Br J Psychiatry 1996; 169: 322-8.
• 83 Strafella AP, Paus T, Barrett J, Dagher A. Repetitive transcranial magnetic stimulation of the human prefrontal cortex induces dopamine release in the caudate nucleus. J Neurosci 2001; 21: RC157.
• 84 Su TP, Huang CC, Wei IH. Add-On rTMS for Medication-Resistant Depression: A Randomized, Double-Blind, Sham-Controlled Trial in Chinese Patients. J Clin Psychiatry 2005; 66: 930-7.
• 85 Teneback CC, Nahas Z, Speer AM, Molloy M, Stallings LE, Spicer KM, Risch SC, George MS. Changes in prefrontal cortex and paralimbic activity in depression following two weeks of daily left prefrontal TMS. J Neuropsychiatry Clin Neurosci 1999; 11: 426-35.
• 86 Thase ME, Rush AJ. When at first you don’t succeed: sequential strategies for antidepressant nonresponders. J Clin Psychiatry 1997; 58 (Suppl. 13) 23-9.
• 87 Wassermann EM. Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5–7, 1996. Electroencephalogr Clin Neurophysiol 1998; 108: 1-16.
• 88 Zwanzger P, Ella R, Keck ME, Rupprecht R, Padberg F. Occurrence of delusions during repetitive transcranial magnetic stimulation (rTMS) in major depression. Biol Psychiatry 2002; 51: 602-3.