| ObjectiveThis study aims to investigate the clinical outcome and cognitive response following repetitive transcranial magnetic stimulation (rTMS) in bipolar â…¡ patients with depressive episodes.MethodsThis prospective, randomized, and controlled study was approved by the Ethics Committee in the First Affiliated Hospital of Zhejiang University. Written informed consents were given by all participants before the initiation of the study. In this study, thirty-nine bipolar â…¡ depressed patients were randomly assigned into three groups:(â…°) left high-frequency (n=13), (â…±) right low-frequency (n=13), (â…²) sham stimulation (n=13), and underwent four-week rTMS with quetiapine concomitantly. Clinical efficacy was evaluated at baseline and weekly intervals using the 17-item Hamilton Depression Rating Scale (HDRS-17) and Montgomery-Asberg Depression Rating Scale (MADRS). Cognitive functioning was assessed before and after the study with the Wisconsin Card Sorting Test (WCST), Stroop Word-Color Interference Test (Stroop), and Trail Making Test (TMT).ResultsThirty-five patients were included in the final analysis. As a result, the mean scores of both the HDRS-17 and the MADRS significantly decreased in each group over the 4-week trial, which did not differ among the three groups at any of the evaluation time point. Exploratory analyses revealed no differences in factor scores of HDRS-17, or in response or remission rates. Scores of WCST, Stroop, or TMT did not differ across the three groups.ConclusionsThese findings indicated active rTMS combined with quetiapine was not superior to quetiapine monotherapy in improving depressive symptoms or cognitive performance in patients with bipolar â…¡ depression. |
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