SHORT REPORT Right frontal lobe slow frequency repetitive transcranial magnetic stimulation (SF r-TMS) is an eVective treatment for depression: a case-control pilot study of safety and eYcacy

Major depression may result from decreased left frontal lobe function with respect to the right. Fast frequency repetitive transcranial magnetic stimulation (FF r-TMS) excites the underlying cortex whereas slow frequency repetitive transcranial magnetic stimulation (SF r-TMS) causes cortical inhibition. Left frontal FF r-TMS attenuates major depression whereas the inhibitory eVects of right frontal SF r-TMS are unknown. This study tested the hypothesis that right frontal SF r-TMS would treat depressed patients with minimal eVect on controls. A psychiatrist administered the Beck depression inventory and Hamilton D depression rating scales to eight depressed patients and six controls before and after the treatment protocol. Eight sessions of 100 right frontal lobe SF r-TMS were given at motor threshold and 0.5 Hz over a 6 week period. No adverse outcomes were noted in either group. A significant antidepressant eVect was noted in depressed patients on the Beck and Hamilton D depression rating scales (p<0.05). No change on either scale was noted in the controls. In conclusion right frontal lobe SF r-TMS is a safe, non-invasive treatment for major depression that deserves further investigation. (J Neurol Neurosurg Psychiatry 1999;67:113–115)