Researchers Explore Effects of rTMS on Patients With Geriatric Depression

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Researchers conducted the first case series study to date exploring the effect of repetitive transcranial magnetic stimulation (rTMS) on patients with geriatric depression.

In exploration of the potential of rTMS as an antidepressant for this patient population, the researchers tested rTMS on depression, neurotrophic factors, cognitive performance, motor-evoked potentials to TMS in geriatric depression, and cerebral blood flow to transcranial Doppler sonography. The study included 6 geriatric participants who were resistant to drug treatments (mean age: 68 years).¹

These participants underwent motor-evoked potentials at baseline and after 3 weeks of 10 Hz rTMS to the left dorsolateral prefrontal cortex. The researchers noted the percentage change of serum nerve growth factor, brain-derived growth factor, insulin-like growth factor-1, vascular endothelial growth factor, and angiogenin. They also conducted assessments at baseline and after rTMS treatment, and performed psychocognitive tests at 1, 3, and 6 months.¹

The researchers found that participants tolerated the rTMS treatment well, with no adverse effects reported. However, although the participants showed improvements in mood after rTMS, these improvements were no longer evident at follow-up. Transcranial Doppler sonography and neurotrophic factors did not change, and electrophysiological data from the treatment also did not change, with the exception of an increase in the right median motor-evoked potential amplitude.¹

However, chronic cerebrovascular disease was observed in 5 participants. The researchers reported that this, along with exposure to multiple pharmacological treatments, might have contributed to the study results.¹

“In this case series study, we were unable to confirm the hypothesis of the study – ie, a multimodal effect of rTMS in geriatric depression,” the researchers concluded. “Both cerebrovascular disease and chronic exposure to multiple pharmacological treatments might have contributed. However, the lack of consistent clinical response suggests that the treatment might be potentially optimized.”

Reference

1. Nicoletti VG, Fisicaro F, Aguglia E, et al. Challenging the pleiotropic effects of repetitive transcranial magnetic stimulation in geriatric depression: a multimodal case series study. Biomedicines. 2023;11(3):958.