Depression Treatment: Efficacy of High-Frequency Repetitive Transcranial Magnetic Stimulation in Treatment-Resistant Depression.

Efficacy of high-frequency repetitive transcranial magnetic stimulation in treatment-resistant depression.

Filed under: Depression Treatment

Clin EEG Neurosci. 2012 Oct; 43(4): 279-84
Tarhan N, Sayar FG, Tan O, Kagan G

We examined the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) in 419 patients with treatment-resistant depression. The patients received daily sessions of rTMS over the left prefrontal cortex as an adjuvant to pharmacotherapy. The rTMS intensity was set at 100% of the motor threshold and 25 Hz stimulation, with train duration of 2 seconds delivered at 30-second intervals. A full course comprised 1000 magnetic pulses. Depression was rated using the Hamilton Depression Rating Scale (HAMD) before and after treatment. Response was defined as a 50% reduction in the HAMD score. Patients with HAMD scores of less than 8 were considered to be in remission. The mean HAMD score for the study group decreased from 22.59 ± 5.92 to 10.50 ± 5.83 (P < .001). After the treatment period, 268 (64%) out of 419 patients demonstrated significant mood improvements, as indexed by a reduction of more than 50% on the HAMD score. In addition, 140 patients (33.4%) attained remission (HAMD score <8); and 11 patients achieved a partial response. Treatment was generally well tolerated, and no serious adverse effects were reported. In conclusion, high-frequency (25 Hz) rTMS was well tolerated and found to be statistically and clinically effective in patients with treatment-resistant depression. This study contributed to the existing evidence of the antidepressant effect of rTMS in the treatment of depression. HubMed – depression

Application of an optogenetic byway for perturbing neuronal activity via glial photostimulation.

Filed under: Depression Treatment

Proc Natl Acad Sci U S A. 2012 Nov 26;
Sasaki T, Beppu K, Tanaka KF, Fukazawa Y, Shigemoto R, Matsui K

Dynamic activity of glia has repeatedly been demonstrated, but if such activity is independent from neuronal activity, glia would not have any role in the information processing in the brain or in the generation of animal behavior. Evidence for neurons communicating with glia is solid, but the signaling pathway leading back from glial-to-neuronal activity was often difficult to study. Here, we introduced a transgenic mouse line in which channelrhodopsin-2, a light-gated cation channel, was expressed in astrocytes. Selective photostimulation of these astrocytes in vivo triggered neuronal activation. Using slice preparations, we show that glial photostimulation leads to release of glutamate, which was sufficient to activate AMPA receptors on Purkinje cells and to induce long-term depression of parallel fiber-to-Purkinje cell synapses through activation of metabotropic glutamate receptors. In contrast to neuronal synaptic vesicular release, glial activation likely causes preferential activation of extrasynaptic receptors that appose glial membrane. Finally, we show that neuronal activation by glial stimulation can lead to perturbation of cerebellar modulated motor behavior. These findings demonstrate that glia can modulate the tone of neuronal activity and behavior. This animal model is expected to be a potentially powerful approach to study the role of glia in brain function.
HubMed – depression

Posttraumatic Stress Disorder and Depression Among U.S. Military Health Care Professionals Deployed in Support of Operations in Iraq and Afghanistan.

Filed under: Depression Treatment

J Trauma Stress. 2012 Nov 26;
Jacobson IG, Horton JL, Leardmann CA, Ryan MA, Boyko EJ, Wells TS, Smith B, Smith TC

Limited prospective studies exist that evaluate the mental health status of military health care professionals who have deployed. This study used prospective data from the Millennium Cohort Study with longitudinal analysis techniques to examine whether health care professionals deployed in support of the operations in Iraq and Afghanistan were more likely to screen positive for new-onset posttraumatic stress disorder (PTSD) or depression after deployment than individuals from other occupations. Of 65,108 subjects included, 9,371 (14.4%) reported working as health care professionals. The rates of new positive screens for PTSD or depression were similar for those in health care occupations (4.7% and 4.3%) compared with those in other occupations (4.6% and 3.9%) for the first and second follow-up, respectively. Among military personnel deployed with combat experience, health care professionals did not have increased odds for new-onset PTSD or depression over time. Among deployed health care professionals, combat experience significantly increased the odds: adjusted odds ratio = 2.01; 95% confidence interval [1.06, 3.83] for new-onset PTSD or depression. These results suggest that combat experience, not features specific to being a health care professional, was the key exposure explaining the development of these outcomes.
HubMed – depression

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