Effects of repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex on the attentional processing of emotional information in major depression: a pilot study.

Repetitive transcranial magnetic stimulation (rTMS) is as a promising therapeutic tool for major depressive disorder. However, the degree of clinical improvement following rTMS treatment still remains questionable. This pilot study aimed at investigating potential working mechanisms of rTMS by examining the effects on attentional processing towards negative information, a proposed underlying cognitive vulnerability factor for depression. The antidepressant effect of high-frequency (10 Hz) rTMS over the left dorsolateral prefrontal cortex and possible effects on the inhibitory processing of emotional information was assessed in a sample of 14 depressed patients immediately after the first stimulation session and at the end of a 2-week treatment period. One session of rTMS caused neither significant self-reported mood changes, nor improvements in inhibitory control towards negative information. After a 10-day treatment period, nine out of our 14 patients demonstrated significant mood improvements, as indexed by a reduction of more than 50% on the Hamilton depression rating scale. Responders also demonstrated significant improvements in the inhibitory processing of negative information. This study contributed to the existing evidence of the antidepressant effect of rTMS in the treatment of depression and additionally was able to demonstrate improvements in underlying deficiencies in inhibitory processes towards negative information.