Table 1.
SPECT/PET TMS Studies: Experimental Design
| Study | N per Group | Neuroimaging Methods (Imaging Interval) | Participants | Study Design | TMS Parameters | ||||
|---|---|---|---|---|---|---|---|---|---|
| Target | Frequency | Intensity (%MT) | Total Sessions a | Total Pulses a | |||||
| Teneback et al., 1999 (43) | Active 13 Sham 9 Total 22 |
SPECT (Pre/Post) | MDD (n=14), Bipolar (n=8) | Sham-controlled (parallel) | L DLPFC | 5Hz or 20Hz | 100 | 10 | 16000 |
| Speer et al., 2000 (44) | Total 10 | PET (Pre/Post) b | TRD (n=8), Bipolar (n=2) | Sham-controlled (crossover) | L DLPFC | 1Hz and 20Hz | 100 | 20 | 16000 per frequency |
| Nahas et al., 2001 (45) | 5Hz 5 20Hz 9 Sham 9 Total 23 |
SPECT (Pre/During 5th session) | MDD (n=16), Bipolar (n=7) | Sham-controlled (crossover) | L DLPFC | 5Hz and 20Hzc | 100 | 10 | 16000 |
| Loo et al., 2003 (46) | Sham/1Hz 9 Sham/15Hz 9 Total 18 |
SPECT (During Sham/Active) d | MDD (n=12), melancholic subtype (n=4); Bipolar (n=2) | Sham-controlled (mixed) | L DLPFC | 1Hz or 15Hz | 90 | 1 | 1Hz: 360 15Hz: 675 |
| Kito et al., 2008 (47) | Total 12 | SPECT (Pre/Post) | TRD | Unblinded | R DLPFC | 1Hz | 100 | 12 | 3600 |
| Baeken et al., 2009 (50) | Total 21 | PET (Pre/Post) | TRD, melancholic subtype | Unblinded | L DLPFC | 10Hz | 110 | 10 | 15600 |
| Kito et al., 2011 (48) | Total 26 | SPECT (Pre/Post) | TRD | Unblinded | R DLPFC | 1Hz | 100 | 12 | 3600 |
| Kito et al., 2012 (49) | Total 26 | SPECT (Pre) | TRD | Unblinded | R DLPFC | 1Hz | 100 | 12 | 3600 |
| Baeken et al., 2015 (51) | Active/sham 9 Sham/active 6 Total 15 |
PET (Pre/Post) b | TRD, melancholic subtype | Sham-controlled (crossover) | L DLPFC | 20Hz | 110 | 20 d | 31200 |
Key: SPECT, single-photon emission computed tomography; PET, positron emission tomography; TMS, transcranial magnetic stimulation; MDD, major depressive disorder; MT, motor threshold; TRD, treatment-resistant depression; L, left; R, right; DLPFC, dorsolateral prefrontal cortex.
a
Upper limit of sessions/pulses
b
Patients completed 2 post-TMS scans, one at the completion of each treatment arm
c
Participants switched to 10Hz at minute 18
d
First SPECT scan took place on day one during sham TMS, 2nd scan took place on day two during active TMS. Scans occurred on consecutive days, 24 hours apart.
e
Five TMS sessions per day (separated by 15–20 minutes)