Low field magnetic stimulation (LFMS) has mood enhancing effects in treatment-resistant depression that accrue with multiple doses, according to study results published in the Journal of Affective Disorders.
Approximately two-thirds of patients with major depressive disorder do not respond adequately to a first trial of antidepressant medication and one-third remain resistant to multiple trials of antidepressants. Electroconvulsive therapy can be effective, but potential adverse cognitive effects limit the use of this treatment option. Newer therapies such as repetitive transcranial magnetic stimulation (rTMS) have shown progress but are costly and inconvenient for patients as they require multiple sessions. LFMS does not evoke neuronal action potentials like TMS, but has demonstrated the ability to modulate metabolism in broad regions of the human cerebral cortex, and it may have safety benefits over TMS.
In a single-site double-blind randomized sham-controlled phase 2 study, Marc J. Dubin, MD, PhD, of the Department of Psychiatry, the Feil Family Brain and Mind Research Institute, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, and colleagues investigated the efficacy of LFMS on mood symptoms in treatment-resistant depression and tried to determine the most effective number of treatment sessions. In the study, 30 patients were assigned to 3 sessions lasting 20 minutes with either active-LFMS (n=15) or sham-LFMS (n=15).
The results of the Hamilton Depression Rating Scale were lower in the active-LFMS group than in the sham group after the final treatment session. Decreases in the number of “Depressed Mood” and Psychic Anxiety” responses account for most of this improvement. The Visual Analog Scale was higher with active-LFMS than with sham treatment, an increase that occurred as early as after the second treatment session, driven primarily by patients reporting being more “Friendly” and less “Hostile,” as well as more “Social” and less “Withdrawn.” The investigators found that the treatment was safe and tolerable and there was no treatment-emergent suicidality.
The primary limitation of the study was the lack of long-term follow-up mood assessments and the short time period between treatment completion and patient assessment. Furthermore, the Hamilton Rating Scale for Depression has only been validated for a 7-day time frame, and this study used a 48-hour time frame.
“In addition to optimizing the dosing protocol and testing the durability of mood improvements, we need to better characterize the subgroup of patients who respond to LFMS,” the investigators concluded.
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Dubin MJ, Ilieva IP, Deng ZD, et al. A double-blind pilot dosing study of low field magnetic stimulation (LFMS) for treatment-resistant depression (TRD). J Affect Disord. 2019;249:286-293.