Repetitive Transcranial Magnetic Stimulation

Repetitive Transcranial Magnetic Stimulation

Objective
Repetitive transcranial magnetic stimulation (rTMS) was approved by the Food and Drug Administration to alleviate symptoms of treatment-resistant depression. This study aimed to evaluate the effectiveness of rTMS treatment on alleviating occupational stress by evaluating clinical symptoms and quantitative electroencephalography (QEEG).
Methods
Twenty-four health care workers were randomized to receive 12 sessions of active or sham rTMS delivered to the left dorsolateral prefrontal cortex (DLPFC). Each session consisted of 32 trains of 10 Hz repetitive TMS delivered in 5-second trains at 110% of the estimated prefrontal cortex threshold. Before and after the intervention, the Korean version of the occupational stress inventory (K-OSI), Beck's depression inventory (BDI), and Beck's anxiety inventory (BAI) were administered and EEG was performed using a 21-channel digital EEG system.
Results
After TMS, the average scores for the affective responses to stressors on the personal strain questionnaire (PSQ) subscale of K-OSI and BDI decreased significantly for the active-TMS group compared to the sham-TMS group. Also, the active-TMS group showed a significantly greater decrease in relative alpha in the F3 electrode and a significantly greater increase in the F4 electrode.
Conclusion
High-frequency rTMS on the left DLPFC had stress-relieving and mood-elevating effects in health care workers, likely by stimulating the left frontal lobe.

Rank: 22
First Author: Kim
Outcome: Stress,Depression,Anxiety,Coping,Strain
Outcome p-value: Stress:●, Depression:⭑⭑, Anxiety:●, Coping:●, Strain:⭑⭑⭑
Intervention Category: Medical
Time per Employee (hours): 2
Hours per Employee: 2
D&B Study Quality Rating: 19
Reviewer Confidence: 4
Country: Korea
Study Design Type: RCT
Materials Available to Implement: Electrode placement and stimulation duration specifications defined in publication: References: George MS, Lisanby SH, Avery D, McDonald WM et al. Arch Gen Psychiatry. 2010 May;67(5):507-16. doi: 10.1001/archgenpsychiatry.2010.46. Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial. DOI: 10.1001/archgenpsychiatry.2010.46. George MS, Avery D, Nahas Z, Molloy M, Oliver NC et al. rTMS studies of mood and emotion. Electroencephalogr Clin Neurophysiol. Suppl. 1999;51:304-314. Author email: sunmikim706@gmail.com
Materials Available: yes
Organiz./Individ. Focus: Individual
Prevention Category: Secondary,Tertiary
Effect Size: Large
Effect size Small:
Effect size Medium:
Effect size Large: Depression,Strain
Reference: Kim, Y. I., Kim, S. M., Kim, H., & Han, D. H. (2016). The Effect of High-Frequency Repetitive Transcranial Magnetic Stimulation on Occupational Stress among Health Care Workers: A Pilot Study. Psychiatry Investigation, 13(6), 622–629. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5128350/pdf/pi-13-622.pdf