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Letters to the Editor
June 2002

Antidepressant Effects of Repetitive Transcranial Magnetic Stimulation in the Elderly: Correlation Between Effect Size and Coil-Cortex Distance

Arch Gen Psychiatry. 2002;59(6):560-561. doi:

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.

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