The Effect of Bilateral Repetitive Transcranial Magnetic Stimulation on Rumination in Patients with Major Depressive Disorder: A Clinical Trial

Rumination in patients with major depressive disorder (MDD) is one of the cognitive risk factors for suffering from mood disorders. On the other hand repetitive transcranial magnetic stimulation (rTMS) as a non-invasive method is applied for treatment of MDD. Therefore, the present study aimed to investigate the effectiveness of rTMS on reducing rumination in patients with MDD. In the present randomized clinical trial study, from among the patients with MDD referring to Atieh Clinical Neuroscience Center in Tehran from December 2016 to September 2017, the number of 64 subjects were selected through convenience sampling method and randomly assigned into two groups of experiment and control. The experimental group during 10 sessions, received 10 rTMS on the left dorsolateral prefrontal cortex with a frequency of 10 Hz and on the same site of cortex at the right site at 1 Hz for two weeks. The control group also received sham rTMS. The patients were first screened using a structural clinical interview and then Ruminative Response Scale was performed before and after the treatment. The data also were analyzed using chi-square test, independent t-test and multivariate analysis of covariance (MANCOVA). Bilateral rTMS caused a significant reduction in rumination (p=0.033) and brooding (p=0.005) compared to the control group. There was observed no significant change in pondering in the two groups (p>0.05). According to the results, rTMS can be considered as a possible treatment for rumination reduction in patients with MDD.