Abstract
Objective The aim of the study was comparative assessment of efficiency of combined TMS included treatment of pharmaco-resistant depression upon reduction of clinical symptoms and neurocognitive deficits. Methods 50 female patients aged 18 to 56 years (mean age 36.3 ± 13.1) with pharmaco-resistant depression (F31.3, F33.0, F33.1 by ICD-10) were enrolled in the study. 23 patients (control group) were treated with SSRI antidepressants, while 27 patients (TMS group) received the same pharmacotherapy together with the course of TMS. Both groups did not differ statistically in demographics parameters and depression severity (mean HDRS-17 scores were 21.0 and 23.2, respectively). High frequency rTMS (25 Hz, intensity of 60–80% of motor threshold, 40 series by 2 s with 14 s intervals–that may be called “beta-bursts” mode, total 1600 pulses, 15 daily sessions) was applied to the projection of the left dorsolateral prefrontal cortex. Relatively low TMS intensity was chosen to prevent facial muscles jerks and to make the procedure more comfortable for patients. Results After 3 weeks of treatment both previously resistant groups demonstrated highly significant (P Conclusions Even low intensity high frequency rTMS of the left dorsolateral prefrontal cortex appeared to be useful method for overcoming the pharmaco-resistance and for improvement of decision-making functions in depressive patients.
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