Repetitive Transcranial Magnetic Stimulation Treatment in Post Stroke Depression

2010 
Introduction: The prevalence of post stroke depression (PSD) ranges between 20% and 65%. It may be associated with functional disability of stroke patients Appropriate treatment of PSD might facilitate their rehabilitation and improve their quality of life. To assess the efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) as treatment modality in post stroke depression. Subjects and Methods: We conducted this study on twenty patients diagnosed as post stroke depression according to DSMVI treated with rTMS at low frequency (1HZ) applied over the left dorsolateral prefrontal cortex for ten sessions in two weeks at 100% of motor threshold. Hamilton Depression Rating Scale (HDRS) was used for rating depression and cognitive assessment for memory, attention and concentration was done before and after TMS treatment. Results: About 60% of our patients showed drop of at least 41.3 % from the relevant phase baseline in scores on the 21-item Hamilton depression scale associated with clinical improvement, pointing that repetitive transcranial magnetic stimulation significantly improved mood in patients with post stroke depression. This effect appears to be maintained over time for one month. Moreover, rTMS showed significant improvement of cognitive tests assessed in this group of patients. Conclusions: TMS could be a promising treatment for patients with stroke complicated by depression with the privilege of fewer side effects previously known to be associated with electroconvulsive therapy and pharmacotherapy. Further studies are indicated to study effects of TMS in large patient population in relation to other technical variables.
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