rTMS in Elderly Depressed:Neuronavegated Study

Repetitive Transcranial Magnetic Stimulation in Elderly Depressed: Neuronavegated Study

This double-blind, controlled and randomized study intents to investigate the antidepressive response of rTMS on the elderly population.This is the first neuronavegated pulse intensity corrected study of rTMS in elderly depressed patients.

Most part of the studies uses samples of severe depressive patients with refractoriness and/or psychotic symptoms, which leave lacuna about the effects on depressive disorder with low or moderate scores. The literature is poor about the use of Repetitive Transcranial Magnetic Stimulation (rTMS) in the old age population.Therefore, we chose this group to research for the antidepressive effect of TMS; other interests are to identify modifications in the magnetic resonance imaging, evaluate cognitive functions and to verify the occurrence of collateral effects and safety use for this specific population.

METHODS:Forty patients with the following criteria:

Inclusion Criteria

• Patients who meet criteria for Major Depressive Episode (MDE) (DSM-IV, 1994; SCID-P, 1994);
• Severity of the episode of mild to moderate
• Aged between 60 and 75 years;
• Both genders;
• In case of previous depressive episode, complete remission of the same for at least 6 weeks as measured by the clinical history;
• washed out of psychotropic drugs for one week, including antidepressants; except fluoxetine, which must have three week interval;
• Granting a written informed consent to participate in the study (Annex II)

Exclusion Criteria:

• metallic cerebral implants
• history of severe trauma or brain injury
• organic brain disease
• severe somatic disease
• history of other psychiatric diseases
• history of Epilepsy
• Non cooperating patients

Scales and Tests of clinical evaluation:

1. Hamilton Depression Rating Scale-17 items
2. Geriatric Depression Scale (GDS)
3. Mini Mental State Examination
4. Clock Drawing Test
5. Clinical Dementia Rating
6. Visual Analogue Scale
7. Clinical Global Impression.