Evidence
J Clin Psychiatry. 2024 May 20;85(2):23m15056. doi: 10.4088/JCP.23m15056.
ABSTRACT
Objective: Repetitive transcranial magnetic stimulation (rTMS) is a standard treatment approach for major depressive disorder. There is growing clinical experience to support the use of high-frequency left-sided rTMS in bipolar depression. This study collected open-label safety and effectiveness data in a sample of patients with bipolar depression.
Methods: Thirty-one adults (13 male/ 18 female; mean age: 42.2 [14.3] years) with bipolar (I or II) depression verified by DSM-5 criteria were recruited at Sheppard Pratt and Mayo Clinic between August 2017 and February 2020 for rTMS. Standardized treatment protocols employed 6 weeks of 10-Hz rTMS to the left dorsolateral prefrontal cortex at 120% of motor threshold with 3,000 pulses per session in 4-second trains with intertrain intervals of 26 seconds. All patients were treated concurrently with a mood stabilizer. The primary outcome measure was the Montgomery-Asberg Depression Rating Scale (MADRS). Response and remission were defined as MADRS score reductions of ≥50% or score <10, respectively. We examined response, remission, and potential contributing factors with multivariate and logistic regression models.
Results: The majority of patients with bipolar depression reached response (n = 27; 87.1%) and remission (n = 23; 74.2%). Older age and concurrent treatment with lithium were associated with higher MADRS scores throughout the treatment course (0.1 ± 0.05, P =.05; 4.05 ± 1.27, P = .003, respectively). Concurrent treatment with lamotrigine was associated with lower MADRS scores (-3.48 ± 1.26, P = .01). Treatment with rTMS was safe and well tolerated. There were no completed suicides, induced manic episodes, or other serious adverse events.
Conclusion: Although preliminary, the present findings are encouraging regarding the safety and effectiveness of 10-Hz rTMS for bipolar depression.
Trial Registration: ClinicalTrials.gov identifier: NCT02640950.
PMID:38780536 | DOI:10.4088/JCP.23m15056
Estimated reading time: 5 minute(s)
Latest: Psychiatryai.com #RAISR4D Evidence
Cool Evidence: Engaging Young People and Students in Real-World Evidence
Real-Time Evidence Search [Psychiatry]
AI Research
A Pilot Study of High-Frequency Transcranial Magnetic Stimulation for Bipolar Depression
🌐 90 Days
AI Virtual Reality Related Evidence Matrix
- Repetitive transcranial magnetic stimulation (rTMS) for depressive-like symptoms in rodent animal models
- Right Ventrolateral and Left Dorsolateral 10 Hz Transcranial Magnetic Stimulation as an Add-On Treatment for Bipolar I and II Depression: a Double-Blind, Randomised, Three-Arm, Sham-Controlled Study
- Psychological Stress Analysis to Evaluate the Effects of Transcranial Magnetic Stimulation on Mood Regulation and Quality of Life in Patients with Bipolar Disorder
- Accelerated transcranial magnetic stimulation for psychological distress in advanced cancer: A phase 2a feasibility and preliminary efficacy clinical trial
- The effect of repetitive transcranial magnetic stimulation on the negative symptoms of chronic schizophrenia and serum brain-derived neurotrophic factor
- Assessing the impact of repetitive transcranial magnetic stimulation on effective connectivity in autism spectrum disorder: An initial exploration using TMS-EEG analysis
- Low-frequency repetitive transcranial magnetic stimulation alleviates abnormal behavior in valproic acid rat model of autism through rescuing synaptic plasticity and inhibiting neuroinflammation
- Effects of repetitive transcranial magnetic stimulation on individual variability of resting-state functional connectivity in major depressive disorder
- Monitoring changes in TMS-evoked EEG and EMG activity during 1 Hz rTMS of the healthy motor cortex
- Navigated and individual α-peak-frequency-guided transcranial magnetic stimulation in male patients with treatment-refractory schizophrenia
- The potential of repetitive transcranial magnetic stimulation for addressing sleep difficulties in children with autism - A brief communication
- Effectiveness of Personalized Hippocampal Network-Targeted Stimulation in Alzheimer Disease: A Randomized Clinical Trial
- Repetitive transcranial magnetic stimulation can improve negative symptoms and/or neurocognitive impairments in the first psychosis episode: A randomized controlled trial
- Multimodal workflows optimally predict response to repetitive transcranial magnetic stimulation in patients with schizophrenia: a multisite machine learning analysis
- Reversing valproic acid-induced autism-like behaviors through a combination of low-frequency repeated transcranial magnetic stimulation and superparamagnetic iron oxide nanoparticles
- Repetitive Transcranial Magnetic Stimulation for Major Depressive Disorder in Huntington Disease Patient with Improvement in Neuropsychiatric and Movement Symptoms: A Case Report
- Facilitated lexical processing accuracy and reaction times following repetitive Transcranial Magnetic Stimulation in dementia of the Alzheimer type: a case study
- The efficacy of low frequency repetitive transcial magnetic stimulation for treating auditory verbal hallucinations in schizophrenia: Insights from functional gradient analyses
- The efficacy of low frequency repetitive transcial magnetic stimulation for treating auditory verbal hallucinations in schizophrenia: Insights from functional gradient analyses
- Assessing the effectiveness of high frequency repetitive transcranial magnetic stimulation for post-mastectomy pain in breast cancer patients: A randomized controlled trial
- Noninvasive brain stimulation of addiction: one target for all?
- Brain stimulation therapeutics
- Brain stimulation therapeutics
- Efficacy and acceptability of noninvasive brain stimulation for treating posttraumatic stress disorder symptoms: A network meta-analysis of randomized controlled trials
- Efficacy of rTMS combined with cognitive training in TBI with cognition disorder: a systematic review and meta-analysis
- Managing the Dual Diagnosis Dilemma of Bipolar Disorder and Substance Abuse in Clinical Settings
- Abnormal Global Cortical Responses in Drug-naïve Patients with Schizophrenia following Orbitofrontal Cortex Stimulation: A Concurrent TMS-EEG Study
- Abnormal Global Cortical Responses in Drug-naive Patients with Schizophrenia following Orbitofrontal Cortex Stimulation: A Concurrent TMS-EEG Study
- Changes in pain following bilateral intermittent theta-burst, transcranial magnetic stimulation for depression: A retrospective chart review
- Theta-burst rTMS in schizophrenia to ameliorate negative and cognitive symptoms: study protocol for a double-blind, sham-controlled, randomized clinical trial
- Pilot study with randomised control of dual site theta burst transcranial magnetic stimulation (TMS) for methamphetamine use disorder: a protocol for the TARTAN study
- Pilot study with randomised control of dual site theta burst transcranial magnetic stimulation (TMS) for methamphetamine use disorder: a protocol for the TARTAN study
- Intermittent theta-burst stimulation to the right dorsolateral prefrontal cortex may increase potentiated startle in healthy individuals
- Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation Across Mental Disorders: A Systematic Review and Dose-Response Meta-Analysis
- Non-pharmacological interventions for improving language and communication in people with primary progressive aphasia
- A Randomized, Double-Blind, Placebo-Controlled Pilot Trial of the Acute Antisuicidal and Antidepressant Effects of Intranasal (R,S)-Ketamine in Severe Unipolar and Bipolar Depression With and Without Comorbid Alcohol Use Disorder
- Magnetic Seizure Therapy vs Modified Electroconvulsive Therapy in Patients With Bipolar Mania: A Randomized Clinical Trial
- Multichannel tDCS with Advanced Targeting for Major Depressive Disorder: A Tele-Supervised At-Home Pilot Study
- Lipid and Glucose Profile across Different Mental Disorders
- A new angle on transcranial magnetic stimulation coil orientation: A targeted narrative review
- Effect of Time From Onset of Major Depressive Disorder on the Therapeutic Response to Esmethadone (REL-1017)
- The effects of deep transcranial magnetic stimulation on Alzheimer's disease: a case report examining cognitive functioning, memory, and QEEG
- Latent profile analysis of vitamin D and its association with depression severity of hospitalized patients with bipolar depression
- Comparing Symptoms of Major Depression in Youth with Confirmed Versus Suspected Bipolar Disorder
- Real-World Effectiveness of Repeated Ketamine Infusions for Treatment-Resistant Bipolar Depression
- Clinical efficacy of deep transcranial magnetic stimulation (dTMS) in psychiatric and cognitive disorders: A systematic review
- The Dropout Rates and Associated Factors in Patients with Mood Disorders in Long-term Naturalistic Treatment
- Psychological Pain as a Risk Factor for Suicidal Ideation: An Ecological Momentary Assessment Study on Inpatients With Depression With and Without Comorbid Borderline Personality Disorder
- Gray matter volume of functionally relevant primary motor cortex is causally related to learning a hand motor task
- Catatonia and melancholia interface: exploring a new paradigm for evaluation and treatment. A case series and literature review
- Bipolar disorder and the gut microbiota: a bibliometric analysis
- Bipolar disorder and the gut microbiota: a bibliometric analysis
- Cariprazine as a maintenance therapy in the prevention of mood episodes in adults with bipolar I disorder
- Clinical decision support for bipolar depression using large language models
- Pediatric Extrapolation Approach for U.S. Food and Drug Administration Approval of Brexpiprazole in Patients Aged 13 to 17 Years with Schizophrenia
- Severe enduring anorexia nervosa (SE-AN) treatment options and their effectiveness: a review of literature
- High-definition transcranial direct current stimulation (HD-tDCS) in major depressive disorder with anxious distress-a study protocol for a double-blinded randomized sham-controlled trial
- Validity of the DSM-5 Mixed Features Specifier Interview
- Validity of the DSM-5 Mixed Features Specifier Interview
- Factors associated with sexual dysfunction in patients with bipolar disorder
- Investigating light sensitivity in bipolar disorder (HELIOS-BD)
- Treatment of Refractory Bipolar Depression With Stereotactic Radiosurgery Targeting the Subgenual Cingulate Cortex
- Treatment of Refractory Bipolar Depression With Stereotactic Radiosurgery Targeting the Subgenual Cingulate Cortex
- Echocardiographic evaluation of myocardial strain in bipolar disorder across different phases: A comparative study with healthy controls
Evidence Blueprint
A Pilot Study of High-Frequency Transcranial Magnetic Stimulation for Bipolar Depression
☊ AI-Driven Related Evidence Nodes
(recent articles with at least 5 words in title)
More Evidence
A Pilot Study of High-Frequency Transcranial Magnetic Stimulation for Bipolar Depression
🌐 365 Days
AI Virtual Reality Related Evidence Matrix
- Repetitive transcranial magnetic stimulation (rTMS) for depressive-like symptoms in rodent animal models
- An Evaluation of the Effectiveness of Repetitive Transcranial Magnetic Stimulation (rTMS) for the Management of Treatment-Resistant Depression with Somatic Attributes: A Hospital-Based Study in Oman
- Effect of prior pharmacotherapy on remission with sequential bilateral theta-burst versus standard bilateral repetitive transcranial magnetic stimulation in treatment-resistant late-life depression
- Pattern of Compliance and Efficacy of Repetitive Transcranial Magnetic Stimulation Protocol for Treating Major Depressive Disorder Among Treatment Participants and Completers: A Report From Iran
- Regulatory Clearance and Approval of Therapeutic Protocols of Transcranial Magnetic Stimulation for Psychiatric Disorders
- Efficacy and safety of intermittent theta burst stimulation versus high-frequency repetitive transcranial magnetic stimulation for patients with treatment-resistant depression: a systematic review
- Right Ventrolateral and Left Dorsolateral 10 Hz Transcranial Magnetic Stimulation as an Add-On Treatment for Bipolar I and II Depression: a Double-Blind, Randomised, Three-Arm, Sham-Controlled Study
- Connectivity-guided intermittent theta burst versus repetitive transcranial magnetic stimulation for treatment-resistant depression: a randomized controlled trial
- Electroconvulsive Therapy Versus Repetitive Transcranial Magnetic Stimulation in Patients With a Depressive Episode: A Register-Based Study
- The Effect of Deep Repetitive Transcranial Magnetic Stimulation with an H1 Coil on Hopelessness in Patients with Major Depressive Disorder: A Randomized Controlled Trial
- Cortical glutamate, Glx, and total N-acetylaspartate: potential biomarkers of repetitive transcranial magnetic stimulation treatment response and outcomes in major depression
- Maintenance repetitive transcranial magnetic stimulation (rTMS) therapy for treatment-resistant depression: a study protocol of a multisite, prospective, non-randomized longitudinal study
- Predictive role of impulsivity, anxiety, and depression in the efficacy of intermittent theta burst transcranial magnetic stimulation modalities for treating methamphetamine use disorder: A randomized clinical trial
- Changes in neuroactive steroids, neurotrophins and immunological biomarkers after monotherapy 8-week rTMS treatment and their relationship with neurocognitive functions in depression
- Psychological Stress Analysis to Evaluate the Effects of Transcranial Magnetic Stimulation on Mood Regulation and Quality of Life in Patients with Bipolar Disorder
- Accelerated transcranial magnetic stimulation for psychological distress in advanced cancer: A phase 2a feasibility and preliminary efficacy clinical trial
- Bilateral Cerebellar Repetitive Transcranial Magnetic Stimulation for Chronic Ataxia After Hemorrhagic Stroke: a Case Report
- Do benzodiazepines reduce the efficacy of transcranial magnetic stimulation?
- The acute effects of repetitive transcranial magnetic stimulation on laminar diffusion anisotropy of neocortical gray matter
- A Meta-Analysis of Transcranial Magnetic Stimulation in Obsessive Compulsive Disorder
- Utility of Repetitive Transcranial Magnetic Stimulation for Chronic Daily Headache Prophylaxis: A Systematic Review and Meta-Analysis
- Repetitive transcranial magnetic stimulation (rTMS) as a tool for cognitive enhancement in healthy adults: a review study
- The effect of repetitive transcranial magnetic stimulation on the negative symptoms of chronic schizophrenia and serum brain-derived neurotrophic factor
- Optimizing TMS Coil Placement Approaches for Targeting the Dorsolateral Prefrontal Cortex in Depressed Adolescents: An Electric Field Modeling Study
- Assessing the impact of repetitive transcranial magnetic stimulation on effective connectivity in autism spectrum disorder: An initial exploration using TMS-EEG analysis
- Low-frequency repetitive transcranial magnetic stimulation alleviates abnormal behavior in valproic acid rat model of autism through rescuing synaptic plasticity and inhibiting neuroinflammation
- Bilateral rTMS Shows No Advantage in Depression nor in Comorbid Depression and Anxiety: A Naturalistic Study
- The role of repetitive transcranial magnetic stimulation therapy in functional bowel disease
- Effects of repetitive transcranial magnetic stimulation on individual variability of resting-state functional connectivity in major depressive disorder
- Monitoring changes in TMS-evoked EEG and EMG activity during 1 Hz rTMS of the healthy motor cortex
- Navigated and individual α-peak-frequency-guided transcranial magnetic stimulation in male patients with treatment-refractory schizophrenia
- Effects of low-Frequency rTMS combined with risperidone on the gut microbiome in Hospitalized Patients with Chronic Schizophrenia
- A preliminary randomized controlled trial of repetitive transcranial magnetic stimulation applied to the left dorsolateral prefrontal cortex in treatment seeking participants with cannabis use disorder
- Repetitive transcranial magnetic stimulation-induced neuroplasticity and the treatment of psychiatric disorders: state of the evidence and future opportunities
- Theta burst stimulation add on to dialectical behavioral therapy in borderline-personality-disorder: methods and design of a randomized, single-blind, placebo-controlled pilot trial
- The use of noninvasive brain stimulation techniques in autism spectrum disorder
- Comparative efficacy of repetitive transcranial magnetic stimulation protocols for obsessive-compulsive disorder: A network meta-analysis
- Study protocol: effects of treatment expectation toward repetitive transcranial magnetic stimulation (rTMS) in major depressive disorder-a randomized controlled clinical trial
- Repetitive Transcranial Magnetic Stimulation With and Without Text4Support for the Treatment of Resistant Depression: Protocol for a Patient-Centered Multicenter Randomized Controlled Pilot Trial
- Low-frequency rTMS induces modifications in cortical structural connectivity - functional connectivity coupling in schizophrenia patients with auditory verbal hallucinations
- Low-frequency rTMS induces modifications in cortical structural connectivity - functional connectivity coupling in schizophrenia patients with auditory verbal hallucinations
- Pre-clinical indications of brain stimulation treatments for non-affective psychiatric disorders, a status update
- The potential of repetitive transcranial magnetic stimulation for addressing sleep difficulties in children with autism - A brief communication
- Adjunctive repetitive transcranial magnetic stimulation for adolescents with first-episode major depressive disorder: a meta-analysis
- Neural mechanisms of emotional health in traumatic brain injury patients undergoing rTMS treatment
- Subgenual cingulate connectivity as a treatment predictor during low-frequency right dorsolateral prefrontal rTMS: A concurrent TMS-fMRI study
- Effectiveness of Personalized Hippocampal Network-Targeted Stimulation in Alzheimer Disease: A Randomized Clinical Trial
- Reduced executive and reward connectivity is associated with smoking cessation response to repetitive transcranial magnetic stimulation: A double-blind, randomized, sham-controlled trial
- Repetitive transcranial magnetic stimulation can improve negative symptoms and/or neurocognitive impairments in the first psychosis episode: A randomized controlled trial
- Studying additive effects of combining rTMS with cognitive control training: a pilot investigation
- Rich-club reorganization of white matter structural network in schizophrenia patients with auditory verbal hallucinations following 1 Hz rTMS treatment
- Multimodal workflows optimally predict response to repetitive transcranial magnetic stimulation in patients with schizophrenia: a multisite machine learning analysis
- Psychomotor Slowing in Psychosis and Inhibitory Repetitive Transcranial Magnetic Stimulation: A Randomized Clinical Trial
- Reversing valproic acid-induced autism-like behaviors through a combination of low-frequency repeated transcranial magnetic stimulation and superparamagnetic iron oxide nanoparticles
- Efficacy of Non-Invasive Brain Stimulation for Treating Depression in Patients with Traumatic Brain Injury: A Meta-Analysis and Meta-Regression of Randomized Controlled Trials
- Abnormal individualized peak functional connectivity toward potential repetitive transcranial magnetic stimulation treatment of autism spectrum disorder
- Repetitive Transcranial Magnetic Stimulation for Major Depressive Disorder in Huntington Disease Patient with Improvement in Neuropsychiatric and Movement Symptoms: A Case Report
- Facilitated lexical processing accuracy and reaction times following repetitive Transcranial Magnetic Stimulation in dementia of the Alzheimer type: a case study
- The efficacy of low frequency repetitive transcial magnetic stimulation for treating auditory verbal hallucinations in schizophrenia: Insights from functional gradient analyses
- The efficacy of low frequency repetitive transcial magnetic stimulation for treating auditory verbal hallucinations in schizophrenia: Insights from functional gradient analyses
- A randomized controlled trial of repetitive transcranial magnetic stimulation plus donepezil vs donepezil alone for mild to moderate cognitive impairment due to small vessel cerebrovascular disease
- Assessing the effectiveness of high frequency repetitive transcranial magnetic stimulation for post-mastectomy pain in breast cancer patients: A randomized controlled trial
- Arketamine for bipolar depression: Open-label, dose-escalation, pilot study
- Efficacy of scalp stimulation for multidomain cognitive impairment in patients with post-stroke cognitive impairment and dementia: A network meta-analysis and meta-regression of moderators