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Distinctive neurocognitive effects of repetitive transcranial magnetic stimulation and electroconvulsive therapy in major depression

Department of Pschiatry, University of Bonn, Germany

Correspondence: Dr Michael Wagner, Department of Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, D 53105 Bonn, Germany.Tel: +49 228 287 6377; fax: +49 228 287 6371; e-mail: michael.wagner{at}ukb.uni-bonn.de

Declaration of interest None.

Background Studies have compared electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) with regard to clinical efficacy in the treatment of depression, but no study has yet addressed the differential impact on cognition.

Aims To compare the neurocognitive effects of unilateral ECTand rTMS.

Method Thirty patients with treatment-refractory non-psychotic major depression received an average of ten treatments with either unilateral ECT or left prefrontal rTMS and were assessed for objective and subjective cognitive impairments before and about a week after treatment.

Results Treatment response was comparable (46% of the ECT group and 44% of the rTMS group showed a reduction of 50% or more in Hamilton Rating Scale for Depression scores). In patients treated with rTMS, cognitive performance remained constant or improved and memory complaints alleviated, whereas in the ECT group memory recall deficits emerged and memory complaints remained.

Conclusions In contrastto unilateral ECT, rTMS has no adverse memory effects.

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