Repetitive transcranial magnetic stimulation (rTMS) is efficient in several neuropsychiatric
conditions such as major depression and neuropathic pain that may co-exist in individual
patients. Genetic factors seem to be crucially involved in the treatment response
that is variable between subjects. The aim of the present study was to investigate
efficacy of rTMS in patients treated for more than one indication with rTMS, testing
hypothesis that treatment response is determined by constitutional within-subject
factors more than by clinical diagnosis and thus, the patient would either benefit
from the treatment in both conditions or not at all. We analyzed 33 clinical patients
(20 women; median age 49 years, range 17 – 75 years) who had undergone serial rTMS
treatment for 1) pain and depression (N=15), 2) depression and anxiety (N=7), 3) depression
and tinnitus (N=6), and 4) other combinations (N=5). E-field navigated TMS device
(Nexstim Ltd, Finland) was used for 10-day serial treatment. Frequency of stimulation
(1 Hz or 10 Hz) and cortical targets varied according to indication. Two patients
dropped out at the beginning because of worsening of symptoms. 30 % decrease in symptom
severity on disorder specific scales was considered a response. Global Impression
of Change (GIC; -3…+3) was available for 20 patients. 31 patients with enough follow-up
data were analyzed: 23 benefitted in more than one indication, 4 benefitted in one
only, and 4 did not get benefit in any indication. Thus, 87 % of the patients either
benefitted in both treatment indications or did not benefit at all. On GIC, 80 % of
patients reported positive change, 20% did not report any change (0). Efficacy did
not depend on age or sex.
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© 2018 Published by Elsevier Inc.