Remission rate of transcranial magnetic stimulation compared with electroconvulsive therapy: a case-control study

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Svensson, Anton FilipSchool of Medical Sciences, Örebro University, Örebro, Sweden (author)

Remission rate of transcranial magnetic stimulation compared with electroconvulsive therapy : a case-control study

Article/chapterEnglish2019

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2018-10-25
Taylor & Francis,2019
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LIBRIS-ID:oai:DiVA.org:oru-69891
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-69891URI
https://doi.org/10.1080/08039488.2018.1481998DOI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Funding Agency:Region Örebro county
PURPOSE: To compare the rate of remission, rate of response, change in depressive symptoms, and adverse effects between repetitive transcranial magnetic stimulation (rTMS) and electroconvulsive therapy (ECT).MATERIALS AND METHODS: In this retrospective case-control study, 35 patients treated for depression with rTMS (left dorsolateral prefrontal cortex, 90% observed motor threshold, 10 Hz, 2000 pulses/session, 15 sessions) at Örebro University Hospital, Sweden (cases), were compared with a matched group of 35 patients treated for depression with ECT (controls). Data on controls were obtained from the Swedish National Quality Register for ECT (Q-ECT). Severity of depression was evaluated using the Montgomery-Åsberg Depression rating scale (MADRS).RESULTS: Remission rate was 26% for cases and 43% for controls (p = .3). Response rate was 40% for cases and 51% for controls (p = .63). The median decrease in MADRS was 11 (IQR 3-19) vs. 17 (IQR 6-27; p = .10) for rTMS and ECT, respectively. There was no statistically significant difference in any measure of treatment effect between rTMS and ECT. More than half of the patients of the rTMS group experienced scalp discomfort and 11% of the ECT group had memory disturbances.CONCLUSIONS: All measures of therapeutic efficacy were numerically inferior in the rTMS group compared to the ECT group. The differences were not statistically significant, probably because the sample size was small. More studies are required to find the optimal place for rTMS within the Swedish health care system. Such studies could be facilitated by inclusion of rTMS in the Q-ECT.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Psykiatri hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Psychiatry hsv//eng
Major depressive disorder
electroconvulsive therapy
repetitive transcranial magnetic stimulation
treatment outcome

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Khaldi, MaherSchool of Medical Sciences, Örebro University, Örebro, Sweden (author)
Engström, Ingemar,1952-Örebro universitet,Institutionen för medicinska vetenskaper,University Health Care Research Center(Swepub:oru)iem (author)
Matusevich, KatsiarynaSchool of Medical Sciences, Örebro University, Örebro, Sweden (author)
Nordenskjöld, Axel,1977-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,University Health Care Research Center(Swepub:oru)alnd (author)
School of Medical Sciences, Örebro University, Örebro, SwedenInstitutionen för medicinska vetenskaper (creator_code:org_t)

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In:Nordic Journal of Psychiatry: Taylor & Francis72:7, s. 471-4760803-94881502-4725

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