Article Highlights
- •Our systematic review found no significant evidence for more pronounced rTMS effects on executive functions in older than in younger adults.
- •The size of the executive function benefits from rTMS in depression was positively related to the effect size of mood symptom reduction.
- •We describe methods that may detect rTMS-driven remediation of both executive processing and mood in depressed patients in future.
Objective
The aims of the current review were to: 1) examine whether the rTMS effects on executive
function increase as age advances; 2) to examine the potential of rTMS to remediate
executive function in older depressed patients; and 3) to assess the relationship
between the executive function and mood benefits from rTMS in depression.
Methods
Randomized or matched-groups, blind, sham-controlled studies (12 studies, 347 participants)
on excitatory rTMS applied to left DLPFC in depression were reviewed.
Results
A series of meta-regressions found no evidence of greater rTMS effects on executive
functions as age advances. Similarly, meta-analyses showed no significant rTMS effects
on executive functions in older depressed individuals. However, meta-regression analyses
showed that the size of the executive function benefits from rTMS in depression are
positively related to the effect size of mood symptom reduction. Despite its correlational
nature, this finding is consistent with the idea that improvement in executive function
may play a critical role in depression recovery.
Conclusions
The authors consider these findings preliminary because of the modest number of available
studies. Based on a qualitative review, the authors describe methodologic modifications
that may increase rTMS efficacy for both executive functions and mood in late-life
depression.
Key Words
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Article info
Publication history
Published online: September 11, 2017
Accepted:
September 5,
2017
Received in revised form:
August 27,
2017
Received:
March 28,
2017
Identification
Copyright
© 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Can Repetitive Transcranial Magnetic Stimulation Enhance Cognitive Control in Late-Life Depression?The American Journal of Geriatric PsychiatryVol. 26Issue 3
- PreviewThe current frontier in the treatment of depression involves the use of non-invasive brain stimulation to target underlying circuit dysfunction. The focal nature of brain stimulation treatments carry the potential for clinician investigators to test hypotheses about treatment that can be verified through discrete cognitive and behavioral measures in combination with assays of biological function (i.e., electroencephalography and functional neuroimaging). The most common form of non-invasive brain stimulation, in use clinically, is repetitive transcranial magnetic stimulation (rTMS).
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