High-, Low-Frequency rTMS Show Similar Antidepressant Effects in PSD

Background: Post-stroke depression (PSD) occurs in roughly 30% of stroke survivors and is associated with worse functional recovery, diminished quality of life, and increased mortality. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a potential neuromodulatory therapy for depression, but comparative data regarding stimulation protocols in PSD remain limited. Objective: To evaluate high-frequency rTMS targeting the left dorsolateral prefrontal cortex (DLPFC) versus low-frequency rTMS targeting the right DLPFC in chronic stroke survivors with PSD. Design: Double-blind, pilot randomized trial. Participants: 11 participants meeting DSM-5 criteria for depression following stroke were randomized. Methods: All participants completed 20 treatment sessions over 4 weeks. Depressive symptoms were assessed using the Hamilton Depression Rating Scale (HAMD), and resting-state electroencephalography (EEG) was obtained at baseline, mid-treatment, and after completion of therapy. more...