Repetitive Transcranial Magnetic Stimulation as Maintenance Treatment of Depression

作者：Yoshihiro Noda, Masataka Wada, Yu Mimura, Keita Taniguchi, Ryosuke Tarumi, Sotaro Moriyama, Naohiro Arai, Sakiko Tsugawa, Kevin E. Thorpe, Zafiris J. Daskalakis, Hiroyuki Uchida, Masaru Mimura, Daniel M. Blumberger, Shinichiro Nakajima · 发表于：JAMA Network Open · 年份：2025 · DOI：10.1001/jamanetworkopen.2025.15881 · 被引用次数：9 · 研究领域：Transcranial Magnetic Stimulation Studies、Pain Management and Treatment、Electromagnetic Fields and Biological Effects

Importance: Depression relapse poses significant medical and economic challenges. Repetitive transcranial magnetic stimulation (rTMS) as maintenance treatment may prevent relapse of treatment-resistant depression (TRD). Objective: To compare the effectiveness between low-frequency rTMS and lithium in preventing TRD relapse. Design, Setting, and Participants: This randomized clinical trial was conducted from September 1, 2018, to May 31, 2023, at Keio University Hospital and Shinjuku-Yoyogi Mental Lab Clinic, Tokyo, Japan, among 75 participants with TRD aged 18 years or older with moderate-to-severe depressive symptoms despite at least 2 adequate antidepressant treatments who subsequently responded to an acute course of bilateral rTMS. Interventions: Participants were randomly assigned at a 1:1 ratio to receive right dorsolateral prefrontal 1-Hz rTMS (24 weekly sessions; 120% of the resting motor threshold, 900 pulses in 15 minutes) or 24-week maintenance treatment with lithium pharmacotherapy. Participants were maintained on the same venlafaxine dose (150-225 mg/d) as the acute-phase dose. Main Outcomes and Measures: The primary outcome was the between-group difference in baseline-adjusted Montgomery-Åsberg Depression Rating Scale (MADRS) scores (range, 0-60, where 0 indicates no symptoms and 60 indicates most severe symptoms) at week 24, which was analyzed using a linear mixed-effects model for repeated measures in an intention-to-treat sample. The secondary outcome was the ...