Tiredness in acute and chronic depression treated with transcranial magnetic stimulation

Abstract

Background: Tiredness is used in some characterizations of major \ndepressive disorder (MDD). Transcranial magnetic stimulation (TMS) lowers all \nsymptoms of MDD. Objective: To explore whether, 1) a visual analogue scale (VAS) \nfor tiredness is a valid and reliable measure of a feature of MDD, and 2) TMS \ntreatment reduces subjective tiredness occurring in MDD. Method: A naturalistic \nstudy of treatment with 10 Hz TMS. Completed pre- and post-treatment: HAMD-6, \na visual analogue scale (VAS-6), the Clinical Global Impression – Severity (CGI-S) \nand a ‘VAS-tiredness’. Two groups received TMS. Acute course: N=52 participants \nsuffering acute MDD, received 20 treatment courses (total courses 86). Relapse \nprevention (RP) course: N=26 participants suffering chronic relapsing MDD received \nscheduled episodic courses over 3 days; (total courses 266). VAS-tiredness scores \nwere compared with the standardized tool results. Results: There were significant \nmedium to large correlations between pre- and post-treatment VAS-tiredness and the \nstandard depression measures (HAMD-6 .406 to .447, VAS-6 .446 to .525, CGI-S \n.348 to .407; all p<.001). TMS treatment produced a significant reduction in VAS tiredness in both (Acute course and RP) groups (main effect: F(1,350)=147.3, \np<.001, η2=.30). The two groups displayed difference in the pre-treatment VAStiredness \nwith the Acute group having higher scores pre-treatment. Post-treatment \ntiredness scores were similar. Conclusion: -tiredness is a valid measure of a \nfeature of MDD. VAS-tiredness provides potentially useful information and complements \nstandard mood tools. TMS treatment can reduce tiredness in MDD.