J Neuropsychiatry Clin Neurosci 12:376-384, August 2000
© 2000 American Psychiatric Press, Inc.
How Coil–Cortex Distance Relates to Age, Motor Threshold, and Antidepressant Response to Repetitive Transcranial Magnetic Stimulation
F. Andrew Kozel, M.D.,
Ziad Nahas, M.D.,
Cart deBrux, B.S.,
Monica Molloy, M.S.N.,
Jeffrey P. Lorberbaum, M.D.,
Daryl Bohning, Ph.D.,
S. Craig Risch, M.D. and
Mark S. George, M.D.
Received August 24, 1999; revised January 12, 2000; accepted January 27, 2000. From the Functional Neuroimaging Division and the Brain Magnetic Stimulation Laboratories, Departments of Psychiatry, Radiology, and Neurology, Medical University of South Carolina; and Psychiatry Department, Ralph H. Johnson VA Medical Center, Charleston, South Carolina. Address correspondence to Dr. Kozel, MUSC Psychiatry Department, 67 President Street, P.O. Box 250861, Charleston, SC 29425; e-mail: kozelfa{at}musc.edu
Repetitive transcranial magnetic stimulation (rTMS) is a tool with antidepressant potential that uses a coil placed on the scalp to produce a powerful magnetic field that directly stimulates only the outermost cortex. MRI scans were obtained in 29 depressed adults involved in an rTMS antidepressant clinical treatment. These scans were analyzed to investigate the effect of distance from coil to cortex on clinical parameters. Longer motor cortex distance, but not prefrontal distance, strongly correlated with increased motor threshold (P<0.01). Clinical antidepressant response did not correlate with either distance. The rTMS antidepressant responders, however, were significantly younger (t=–2.430, P<0.05), and there appears to be a maximum threshold of age and distance to prefrontal cortex for response.
Key Words: Transcranial Stimulation • Motor Threshold • Motor Cortex
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