Title
TMS by double-cone coil prefrontal stimulation for medication resistant chronic depression : a case report TMS by double-cone coil prefrontal stimulation for medication resistant chronic depression : a case report
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Oxford ,
Subject
Psychology
Human medicine
Source (journal)
Neurocase. - Oxford, 1997, currens
Volume/pages
20(2014) :1 , p. 61-68
ISSN
1355-4794
ISI
000327371800009
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
A double-cone coil with large angled windings has been developed to modulate deeper brain areas such as the anterior cingulate cortex (ACC). Abnormal resting state activity in the pregenual ACC (pgACC), dorsal ACC (dACC) and subgenual ACC (sgACC) has been observed in depression. A patient with medication resistant chronic depression received ten sessions of transcranial magnetic stimulation (TMS) (10 Hz, 2000 stimuli/session) using a double-cone coil placed over the supplementary motor area, targeting the anterior cingulate. Source localized EEG recordings were conducted pre- and post-TMS. The Beck Depression Inventory (BDI-II) improved by 27%, and the two subscales of the Hospital Anxiety Depression Scale (HADS), namely depression (40%) and anxiety (33%) improved as well. Along with the clinical improvement eletrophysiological resting state activity changed in the dACC and sgACC in this patient in comparison to a normative group. The results of this case report further support the involvement of pgACC, dACC and sgACC activity in the pathophysiology of depression and indicate that modulation of neural activity in this area by high frequency TMS with a double-cone coil might represent a new promising approach in the treatment of medication resistant chronic depression.
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