TY - JOUR
T1 - Mitochondrial myopathy and comorbid major depressive disorder
T2 - Effectiveness of dTMS on gait and mood symptoms
AU - Rapinesi, Chiara
AU - Janiri, Delfina
AU - Kotzalidis, Georgios D.
AU - Serata, Daniele
AU - Del Casale, Antonio
AU - Scatena, Paola
AU - Dacquino, Claudia
AU - Gentile, Giovanna
AU - Manfredi, Giovanni
AU - Danese, Emanuela
AU - Raccah, Ruggero Nessim
AU - Brugnoli, Roberto
AU - Callovini, Gemma
AU - Ferri, Vittoria Rachele
AU - Ferracuti, Stefano
AU - Zangen, Abraham
AU - Simmaco, Maurizio
AU - Angeletti, Gloria
AU - Girardi, Paolo
N1 - Publisher Copyright:
© 2015 .
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Background: Mitochondrial myopathies (MMs) often present with leukoencephalopathy and psychiatric symptoms, which do not respond to or worsen with psychiatric drugs. Case report: A 67-year-old woman with a 10-year history of probable chronic progressive external ophthalmoplegia, an MM, had drug-resistant, anxious-depressive symptoms. Since she had never had seizures, we proposed 20 sessions of deep transcranial magnetic stimulation (dTMS) for her depression. Surprisingly, besides the expected improvement of depression, we observed marked improvement of movement disorder that lasted as long as the patient was undergoing dTMS. She also improved her performance on neuropsychological tests of executive function and cognitive speed. Depressive symptom improvement was persistent, while anxiety symptoms recurred after the end of the sessions. Conclusions: dTMS may be an alternative antidepressant strategy in patients with MMs, provided that they are free from seizures. The mechanism of improvement of motor disturbance may relate to dorsolateral prefrontal cortex stimulation and improved executive function and needs further investigation.
AB - Background: Mitochondrial myopathies (MMs) often present with leukoencephalopathy and psychiatric symptoms, which do not respond to or worsen with psychiatric drugs. Case report: A 67-year-old woman with a 10-year history of probable chronic progressive external ophthalmoplegia, an MM, had drug-resistant, anxious-depressive symptoms. Since she had never had seizures, we proposed 20 sessions of deep transcranial magnetic stimulation (dTMS) for her depression. Surprisingly, besides the expected improvement of depression, we observed marked improvement of movement disorder that lasted as long as the patient was undergoing dTMS. She also improved her performance on neuropsychological tests of executive function and cognitive speed. Depressive symptom improvement was persistent, while anxiety symptoms recurred after the end of the sessions. Conclusions: dTMS may be an alternative antidepressant strategy in patients with MMs, provided that they are free from seizures. The mechanism of improvement of motor disturbance may relate to dorsolateral prefrontal cortex stimulation and improved executive function and needs further investigation.
KW - Comorbidity
KW - Deep transcranial magnetic stimulation (dTMS)
KW - Dorsolateral prefrontal cortex (DLPFC)
KW - Major depressive disorder
KW - Mitochondrial myopathy
UR - http://www.scopus.com/inward/record.url?scp=84930181610&partnerID=8YFLogxK
U2 - 10.1016/j.genhosppsych.2015.03.002
DO - 10.1016/j.genhosppsych.2015.03.002
M3 - Article
AN - SCOPUS:84930181610
SN - 0163-8343
VL - 37
SP - 274.e7-274.e9
JO - General Hospital Psychiatry
JF - General Hospital Psychiatry
IS - 3
ER -