Several controlled studies suggest that high-frequency repetitive transcranial
magnetic stimulation is associated with antidepressant effects.1-5
Interestingly enough, the 2 studies investigating relatively older depressed
patients2,5 demonstrated
a lesser effect than did the studies performed in a younger population. This
is in stark contrast to the finding that another method of brain stimulation,
electroconvulsive therapy, is somewhat more effective in older patients.6 Figiel et al2
assumed that this finding could be associated with the structural brain changes
that are often found in older depressed patients.7
Lai and colleagues8 were recently able to
demonstrate an orbitofrontal cortex volume reduction in geriatric depressed
patients. Kozel et al9 investigated the
relationship of the distance between the stimulating coil and the cortex to
age and antidepressant response and were not able to find a significant correlation
in 12 patients with a mean age of 42 years; however, they demonstrated that
treatment responders were younger and had a shorter prefrontal coil-cortex
distance.