Effects of repetitive transcranial magnetic stimulation on clinical, social, and cognitive performance in postpartum depression

Abstract

Martin Luiz Myczkowski,1 Álvaro Machado Dias,1,2 Tatiana Luvisotto,1 Debora Arnaut,1 Bianca Boura Bellini,1 Carlos Gustavo Mansur,1 Joel Rennó,1 Gabriel Tortella,1 Philip Leite Ribeiro,1 Marco Antônio Marcolin11Institute of Psychiatry, University of São Paulo, Medical School São Paulo, 2Clinical Neuroscience Laboratory of the Federal University of São Paulo, São Paulo, BrazilBackground: This randomized, placebo-controlled, double-blind pilot study evaluated the impact of repetitive transcranial magnetic stimulation (rTMS) on clinical, cognitive, and social performance in women suffering with postpartum depression.Methods: Fourteen patients were randomized to receive 20 sessions of sham rTMS or active 5 Hz rTMS over the left dorsolateral prefrontal cortex. Psychiatric clinical scales and a neuropsychological battery were applied at baseline (pretreatment), week 4 (end of treatment), and week 6 (follow-up, posttreatment week 2).Results: The active rTMS group showed significant improvement 2 weeks after the end of rTMS treatment (week 6) in Hamilton Depression Rating Scale (P = 0.020), Global Assessment Scale (P = 0.037), Clinical Global Impression (P = 0.047), and Social Adjustment Scale-Self Report-Work at Home (P = 0.020).Conclusion: This study suggests that rTMS has the potential to improve the clinical condition in postpartum depression, while producing marginal gains in social and cognitive function.Keywords: transcranial magnetic stimulation, postpartum depression, clinical performance, cognitive performance, social performance