Comparison Of The Efficacy Of Unilateral And Bilateral Repetitive Transcranial Magnetic Stimulation Combined With Escitalopram In The Treatment In The Acute Phase Of Depression

Objective:To compare the efficacy of left high frequency and bilateral sequential repetitive transcranial magnetic stimulation in the treatment of clinical symptoms in acute stage of depression disorder.Methods:63 patients with moderate depressive disorder were randomized to receive unilateral high-frequency repetitive transcranial magnetic stimulation(2100 pulses at 10 Hz)in the left dorsolateral prefrontal cortex(DLPFC),sequential bilateral transcranial magnetic stimulation(B600 pulses at 1 Hz in right DLPFC followed by 1500 pulses at 10 Hz in left DLPFC)for 2 weeks.The control group was not given stimulation.Hamilton Depression scale(HAMD-17)and self-rating Depression scale(SDS)were used to evaluate the depressive symptoms before and after the treatment.The sleep symptoms were compared with the Pittsburgh Sleep scale((PSQI))and the sleep disorder factor scores extracted from HAMD.Results:Except for the PSQI scale,there was no significant difference among the three groups in the baseline score.Three patients withdrew from the study in the bilateral and the control group.After 2weeks treatment,the was a significant improvement in depressive symptomatology,measured by scores on the HAMD-17,SDS and insomnia factors in the three groups were significantly lower than those before treatment(P<0.01).The difference between the three groups was not significant(P>0.05).There were few adverse reactions in the three groups,and there were no serious related adverse events.Conclusion:Both left highfrequency and bilateral sequential transcranial magnetic stimulation can effectively treat depression.High frequency repetitive transcranial magnetic stimulation on the left isequivalent to bilateral treatment.