Effects of Deep Transcranial Magnetic Stimulation on Cognitive Function in Bipolar Depression: A Randomized...

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Trials

Background:

• Bipolar disorder (BD) is marked by persistent cognitive deficits impacting daily function.
• These cognitive issues often resist standard pharmacotherapy.
• Deep transcranial magnetic stimulation (dTMS) shows antidepressant effects, but its cognitive impact in BD is understudied.

Purpose of the Study:

• To evaluate the cognitive outcomes, clinical efficacy, and safety of H1-coil dTMS in patients with bipolar disorder.
• To compare the effects of active dTMS versus sham stimulation on cognitive function and depressive symptoms.

Main Methods:

• A randomized, double-blind, sham-controlled trial involving 100 inpatients with BD.
• Participants received 4 weeks of either active or sham H1-coil dTMS.
• Cognitive function was assessed using the MATRICS Consensus Cognitive Battery (MCCB), and depressive symptoms via the 17-item Hamilton Depression Rating Scale (HDRS-17).

Main Results:

• Both active and sham dTMS groups showed significant cognitive improvements across most domains.
• The active dTMS group exhibited significantly lower HDRS-17 scores and a higher response rate compared to the sham group (50% vs. 24%).
• All treatments were well-tolerated with mild, transient adverse effects.

Conclusions:

• Active dTMS is well-tolerated in BD patients, offering improved depressive symptoms and response rates without cognitive harm.
• No specific cognitive benefits beyond antidepressant effects were observed.
• dTMS presents potential as an adjunctive therapy for bipolar depression, especially when pharmacotherapy is limited or poorly tolerated.