Original Research ARTICLE

Front. Psychiatry, 12 December 2013 | http://dx.doi.org/10.3389/fpsyt.2013.00165

Neurocognitive effects of repetitive transcranial magnetic stimulation in adolescents with major depressive disorder

imageChristopher A. Wall1,2*, imagePaul E. Croarkin1,2, imageShawn M. McClintock3,4, imageLauren L. Murphy1, imageLorelei A. Bandel1, imageLeslie A. Sim1,2 and imageShirlene M. Sampson1
  • 1Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
  • 2Division of Child and Adolescent Psychiatry, Mayo Clinic, Rochester, MN, USA
  • 3Neurocognitive Research Laboratory, Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
  • 4Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

Objectives: It is estimated that 30–40% of adolescents with major depressive disorder (MDD) do not receive full benefit from current antidepressant therapies. Repetitive transcranial magnetic stimulation (rTMS) is a novel therapy approved by the US Food and Drug Administration to treat adults with MDD. Research suggests rTMS is not associated with adverse neurocognitive effects in adult populations; however, there is no documentation of its neurocognitive effects in adolescents. This is a secondary post hoc analysis of neurocognitive outcome in adolescents who were treated with open-label rTMS in two separate studies.

Methods: Eighteen patients (mean age, 16.2 ± 1.1 years; 11 females, 7 males) with MDD who failed to adequately respond to at least one antidepressant agent were enrolled in the study. Fourteen patients completed all 30 rTMS treatments (5 days/week, 120% of motor threshold, 10 Hz, 3,000 stimulations per session) applied to the left dorsolateral prefrontal cortex. Depression was rated using the Children’s Depression Rating Scale-Revised. Neurocognitive evaluation was performed at baseline and after completion of 30 rTMS treatments with the Children’s Auditory Verbal Learning Test (CAVLT) and Delis–Kaplan Executive Function System Trail Making Test.

Results: Over the course of 30 rTMS treatments, adolescents showed a substantial decrease in depression severity. Commensurate with improvement in depressive symptoms was a statistically significant improvement in memory and delayed verbal recall. Other learning and memory indices and executive function remained intact. Neither participants nor their family members reported clinically meaningful changes in neurocognitive function.

Conclusion: These preliminary findings suggest rTMS does not adversely impact neurocognitive functioning in adolescents and may provide subtle enhancement of verbal memory as measured by the CAVLT. Further controlled investigations with larger sample sizes and rigorous trial designs are warranted to confirm and extend these findings.

Keywords: adolescents, depression, neurocognition, memory, learning, TMS

Citation: Wall CA, Croarkin PE, McClintock SM, Murphy LL, Bandel LA, Sim LA and Sampson SM (2013) Neurocognitive effects of repetitive transcranial magnetic stimulation in adolescents with major depressive disorder. Front. Psychiatry 4:165. doi: 10.3389/fpsyt.2013.00165

Received: 01 October 2013; Paper pending published: 18 October 2013;
Accepted: 25 November 2013; Published online: 12 December 2013.

Edited by:

Stephanie Ameis, University of Toronto, Canada

Reviewed by:

Peter G. Enticott, Deakin University, Australia
Daniel Blumberger, Centre for Addiction and Mental Health, Canada

Copyright: © 2013 Wall, Croarkin, McClintock, Murphy, Bandel, Sim and Sampson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Christopher A. Wall, Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street South West, Rochester, MN 55905, USA e-mail: wall.chris@mayo.edu