Depression is a common complication of Parkinson?s disease (PD), and may express a sinister synergy in exacerbating symptoms of psychomotor retardation. Whether the underlying biology of depression in PD differs from that of other geriatric depression is unknown.
We carried out a double-blind, placebo-controlled, crossover study of rapid repetitive transcranial magnetic stimulation (rTMS) in PD patients with refractory depression. Patients were admitted to the General Clinical Research Center of Emory University Hospital for baseline testing, two separate weeks of real or placebo treatment, and two followup visits after each week of treatment. RTMS was performed over the left prefrontal region at 100% of resting motor threshold, 10 Hz, 2000 pulses/day. The placebo treatments provided identical sound and a similar sensation of vibration, but no significant magnetic field.
Treatment response was assessed by HDRS, HARS, BDI, PDQ-39, GAF, CGI, BPRS, FIM, RBANS, BTA, BDS, Hoehn and Yahr staging, Schwab and England ADL, UPDRS on and off medication, and additional timed performance tests.
This study is expected to end in August, 2003, and the blind will be broken shortly before this symposium.