Increased cortical excitability with prefrontal high-frequency repetitive transcranial magnetic stimulation in adolescents with treatment-resistant major depressive disorder

Paul E. Croarkin, Christopher A. Wall, Paul A. Nakonezny, Jeylan S. Buyukdura, Mustafa M. Husain, Shirlene M. Sampson, Graham J. Emslie, F. Andrew Kozel

Research output: Contribution to journalArticle

17 Scopus citations


Objective: To examine changes in motor cortical excitability in adolescent subjects receiving 30 sessions of high-frequency prefrontal repetitive transcranial magnetic stimulation (rTMS). Methods: Eight adolescents with treatment-resistant major depressive disorder (MDD) enrolled in an open augmentation trial of 10 Hz rTMS. Resting motor thresholds were obtained by the visualization of movement method with a maximum likelihood threshold hunting computer algorithm at baseline and after every five sessions of rTMS. Motor threshold was recorded as the percentage of total machine output at each measurement. Results: Motor threshold data from baseline, weeks 2, 4, and 5 were included in a mixed model repeated measure analysis to examine a change in least square mean effect over time. The omnibus effect did not reach statistical significance (F=1.25, p=0.32). However, multiple comparisons from the overall model demonstrated a decrease in the least square mean motor threshold. The mean contrast from baseline to week 5 approached significance (p=0.07). Moreover, a post-hoc analysis with a Wilcoxon signed ranks test demonstrated a significant decrease at week 5 (p=0.03). Conclusions: This suggests that high-frequency rTMS may increase cortical excitability in adolescents with treatment-resistant MDD.

Original languageEnglish (US)
Pages (from-to)56-64
Number of pages9
JournalJournal of Child and Adolescent Psychopharmacology
Issue number1
Publication statusPublished - Feb 1 2012


ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health

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