High frequency repetitive transcranial magnetic stimulation versus sertraline in treatment of poststroke depression: A pilot study

Authors

  • Pim Terachinda Chulalongkorn University, Bangkok, Thailand
  • Anuphan Tantanatip Chulalongkorn University, Bangkok, Thailand
  • Krisna Piravej Chulalongkorn University, Bangkok, Thailand
  • Sookjareon Tangwongchai Chulalongkorn University, Bangkok, Thailand
  • Sunisa Srioum Thai Red Cross Rehabilitation Center, Thai Red Cross Society, Samut Prakarn, Thailand
  • Thipwimon Sillapachai Thai Red Cross Rehabilitation Center, Thai Red Cross Society, Samut Prakarn, Thailand
  • Pisamai Hongsachat Thai Red Cross Rehabilitation Center, Thai Red Cross Society, Samut Prakarn, Thailand
  • Yuda Chongpison Center of Excellence in Biostatistics, Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Keywords:

Stroke, depression, repetitive transcranial magnetic stimulation, sertraline

Abstract

Background: Poststroke depression (PSD) has impact on rehabilitation outcome. Repetitive transcranial magnetic stimulation (rTMS) has been proven as a treatment of depression and might reduce depressive symptoms after stroke.

Objectives: To determine the effects of high frequency rTMS in treatment of PSD compared to sertraline. We also investigated the effects of rTMS combined with sertraline.

Methods: Fourteen patients with PSD were randomly allocated into 3 groups: 1) the rTMS group received 10 sessions of 10 Hz rTMS; 2) the sertraline group obtained sertraline 50 mg daily and sham rTMS; and, 3) the combined group received 10 Hz rTMS combined with sertraline 50 mg daily. Hamilton rating scale for depression (HAM-D) was assessed at baseline and week 2, 6 and 14. At baseline and week 6 and 14, modified Barthel Index (MBI) and Brunnstrom stages of stroke recovery were evaluated.

Results: The rTMS group showed significant reduction of HAM-D score at week 6 (- 9.8 gif.latex?\pm 7.1; P < 0.05) while the sertraline and combined groups did not show significant improvement (- 9.2 gif.latex?\pm 1.0 and - 4.8 gif.latex?\pm 2.9, respectively). HAM-D, response and remission rate, response and remission over the time, MBI and motor recovery among groups were not significantly different.

Conclusion: High frequency rTMS might have antidepressant effect in PSD. Its effect might not be different from sertraline. Benefit of rTMS given in combination with sertraline over rTMS or sertraline alone is still inconclusive.

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Published

2023-10-17

How to Cite

1.
Terachinda P, Tantanatip A, Piravej K, Tangwongchai S, Srioum S, Sillapachai T, Hongsachat P, Chongpison Y. High frequency repetitive transcranial magnetic stimulation versus sertraline in treatment of poststroke depression: A pilot study. Chula Med J [Internet]. 2023 Oct. 17 [cited 2024 May 20];65(1). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/1077

Issue

Vol. 65 No. 1 (2021): Chulalongkorn Medical Journal

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Other

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