Intermittent theta burst stimulation (iTBS) of the left dorsolateral prefrontal cortex (LDPFC) was not efficient remedy for important depressive episodes amongst patients with bipolar disorder. These findings, from a randomized, double-blind clinical trial, had been published in JAMA Network Open.
Patients (N=37) with bipolar disorder had been recruited from the University of British Columbia and the University of Calgary in Canada among 2016 and 2020. Participants had been randomized to 4 weeks of active iTBS (n=18) or sham (n=19) remedy which comprised 600 pulses of 50 Hz triplets repeated at 5 Hz (2 seconds on, 8 seconds off) targeted at the LDPFC. Depression was assessed by the Montgomery-Asberg Depression Rating Scale (MADRS) at baseline, 2, and 4 weeks.
Patients had been aged imply 43.86 (common deviation [SD], 13.87) years, 62.2% had been ladies, 91.9% had been White, 56.8% had bipolar disorder variety 1, 48.6% had been on a mood stabilizer and atypical antipsychotic, and the present depressive episode has lasted an typical of 32.45 (SD, 34.29) weeks.
The reduce in MADRS depression score amongst patients who believed they had active iTBS was 47.47% (SD, 30.44%) and amongst these who believed they received sham remedy was 14.84% (SD, 22.03% t, 3.41 P =.002). The distribution of patients believing they had been getting sham or active remedy was center certain (P =.03).
Compared with baseline, patients reported a least-squares imply distinction in MADRS of -1.36 (95% CI, -8.92 to 6.19 P =.91) favoring the sham remedy. A total of 3 patients in every group reported a clinical response of ³50%.
Stratified by bipolar sorts there was no impact of iTBS remedy (t, .33 P =.74). Stratified by medication, no impact was observed amongst patients who had been on lamotrigine (t, .47 P =.64), lithium (t, .69 P =.49), or valproate (t, .54 P =.59).
This study may possibly have been biased by the integrity of the internet site-certain blinding.
These information indicated there was small advantage from iTBS of the LDPFC for the remedy of depressive episodes amongst patients with bipolar disorder.
Disclosure: Multiple authors declared affiliations with market. Please refer to the original write-up for a complete list of disclosures.
McGirr A, Vila-Rodriguez F, Cole J, et al. Efficacy of active vs sham intermittent theta burst transcranial magnetic stimulation for patients with bipolar depression: a randomized clinical trial. JAMA Netw Open. Published on line March 12, 2021. doi:10.1001/jamanetworkopen.2021.0963.