Open Access Open Badges Research article

Cognitive correlates of repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant depression- a pilot study

Karina K Kedzior1*, Vikram Rajput23, Greg Price23, Joseph Lee23 and Mathew Martin-Iverson23

Author Affiliations

1 School of Humanities and Social Sciences, Jacobs University Bremen, Campus Ring 1, Bremen, 28759, Germany

2 Clinical Neurophysiology Unit, Graylands Hospital, John XXIII Avenue, Mt Claremont, Perth, 6010, Australia

3 Pharmacology & Anaesthesiology Unit, School of Medicine & Pharmacology, Faculty of Medicine, Dentistry & Health Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, 6009, Australia

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BMC Psychiatry 2012, 12:163  doi:10.1186/1471-244X-12-163

Published: 2 October 2012



The aim of the current study was to investigate the cognitive correlates of repetitive transcranial magnetic stimulation (rTMS) in 10 treatment-resistant depression patients.


Patients received forty 20-min sessions of fast-frequency (10 Hz) rTMS of the left dorsolateral prefrontal cortex (DLPFC) over 20 days. Concept-shift ability (accuracy and duration of performance) was assessed daily with a Modified Concept-Shifting Task (mCST) in patients and in eight healthy volunteers. General cognitive functioning test (Repeatable Battery for the Assessment of Neuropsychological Status; RBANS), Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HAM-D) were applied before the first and after the last rTMS.


Compared to before rTMS on the first 10 days, the patients performed the mCST significantly more accurately after rTMS on the last 10 days (p < .001, partial eta squared=.78) while the same comparison in healthy volunteers was not statistically significant (p = .256, partial eta squared=.18). A significant improvement in immediate memory on RBANS and reduction in BDI and HAM-D scores were also observed after the last compared to before the first rTMS.


The rTMS is associated with an improvement in selective cognitive functions that is not explained by practice effects on tasks administered repeatedly.

Trial registration

Name: "Repetitive Transcranial Magnetic Stimulation (rTMS) in the treatment of depression, assessed with HAM-D over a four week period."


Registration number: ACTRN012605000145606

Repetitive transcranial magnetic stimulation (rTMS); Treatment-resistant depression; Modified concept-shifting task (mCST); Left dorsolateral prefrontal cortex (DLPFC)