Magnetic seizure therapy (MST) for major depressive disorder

Zafiris J. Daskalakis, Julia Dimitrova, Shawn M. McClintock, Yinming Sun, Daphne Voineskos, Tarek K. Rajji, David S. Goldbloom, Albert H.C. Wong, Yuliya Knyahnytska, Benoit H. Mulsant, Jonathan Downar, Paul B. Fitzgerald, Daniel M. Blumberger

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Electroconvulsive therapy (ECT) is effective for major depressive disorder (MDD) but its effects on memory limit its widespread use. Magnetic seizure therapy (MST) is a potential alternative to ECT that may not adversely affect memory. In the current trial, consecutive patients with MDD consented to receive MST applied over the prefrontal cortex according to an open-label protocol. Depressive symptoms and cognition were assessed prior to, during and at the end of treatment. Patients were treated two to three times per week with high-frequency MST (i.e., 100 Hz) (N = 24), medium frequency MST (i.e., 60 or 50 Hz) (N = 26), or low-frequency MST (i.e., 25 Hz MST) (N = 36) using 100% stimulator output. One hundred and forty patients were screened; 86 patients with MDD received a minimum of eight treatments and were deemed to have an adequate course of MST; and 47 completed the trial per protocol, either achieving remission (i.e., 24-item Hamilton Rating Scale for Depression score <10 and a relative reduction of >60% at two consecutive assessments; n = 17) or received a maximum of 24 sessions (n = 30). High-frequency (100 Hz) MST produced the highest remission rate (33.3%). Performance on most cognitive measures remained stable, with the exception of significantly worsened recall consistency of autobiographical information and significantly improved brief visuospatial memory task performance. Under open conditions, MST led to clinically meaningful reduction in depressive symptoms in patients with MDD and produced minimal cognitive impairment. Future studies should compare MST and ECT under double-blind randomized condition.

Original languageEnglish (US)
JournalNeuropsychopharmacology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Major Depressive Disorder
Seizures
Electroconvulsive Therapy
Therapeutics
Depression
Task Performance and Analysis
Clinical Protocols
Prefrontal Cortex
Cognition

ASJC Scopus subject areas

  • Pharmacology
  • Psychiatry and Mental health

Cite this

Daskalakis, Z. J., Dimitrova, J., McClintock, S. M., Sun, Y., Voineskos, D., Rajji, T. K., ... Blumberger, D. M. (Accepted/In press). Magnetic seizure therapy (MST) for major depressive disorder. Neuropsychopharmacology. https://doi.org/10.1038/s41386-019-0515-4

Magnetic seizure therapy (MST) for major depressive disorder. / Daskalakis, Zafiris J.; Dimitrova, Julia; McClintock, Shawn M.; Sun, Yinming; Voineskos, Daphne; Rajji, Tarek K.; Goldbloom, David S.; Wong, Albert H.C.; Knyahnytska, Yuliya; Mulsant, Benoit H.; Downar, Jonathan; Fitzgerald, Paul B.; Blumberger, Daniel M.

In: Neuropsychopharmacology, 01.01.2019.

Research output: Contribution to journalArticle

Daskalakis, ZJ, Dimitrova, J, McClintock, SM, Sun, Y, Voineskos, D, Rajji, TK, Goldbloom, DS, Wong, AHC, Knyahnytska, Y, Mulsant, BH, Downar, J, Fitzgerald, PB & Blumberger, DM 2019, 'Magnetic seizure therapy (MST) for major depressive disorder', Neuropsychopharmacology. https://doi.org/10.1038/s41386-019-0515-4
Daskalakis, Zafiris J. ; Dimitrova, Julia ; McClintock, Shawn M. ; Sun, Yinming ; Voineskos, Daphne ; Rajji, Tarek K. ; Goldbloom, David S. ; Wong, Albert H.C. ; Knyahnytska, Yuliya ; Mulsant, Benoit H. ; Downar, Jonathan ; Fitzgerald, Paul B. ; Blumberger, Daniel M. / Magnetic seizure therapy (MST) for major depressive disorder. In: Neuropsychopharmacology. 2019.
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