DOI: 10.57127/kpd.26024438.1915597 ISSN: 2602-4438

Changes in depression, anxiety, and affect following repetitive transcranial magnetic stimulation applied to the left dorsolateral prefrontal cortex: A quasi-experimental study

Fatma Mahperi Uluyol, Mehmet Murat Kuloğlu, Sıla Demirci
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In recent years, repetitive transcranial magnetic stimulation (rTMS) has become an increasingly prominent neuromodulation approach in the treatment of Major Depressive Disorder (MDD). Treatment success in the literature is predominantly evaluated in terms of reductions in depressive symptom levels, while changes in anxiety symptoms and in positive and negative affect—dimensions that frequently accompany MDD—are largely overlooked in such evaluations. Accordingly, the present study examined changes in depressive symptoms, anxiety symptoms, and positive and negative affect following rTMS administered as an adjunct to pharmacotherapy. The study employed a single-group, pre-test–post-test quasi-experimental design without a control group. Thirty patients diagnosed with MDD (22 women, 8 men; Mage = 41.73 ± 14.95 years) were included. High-frequency rTMS was applied to the left dorsolateral prefrontal cortex (DLPFC) at 10 Hz, at 120% of motor threshold intensity, with 3,000 pulses per session. Treatment was administered five days per week for a total of 30 sessions. A repeated-measures MANOVA revealed a significant multivariate effect of time, Pillai's Trace = .53, F(4, 26) = 7.24, p < .001, η²p = .53. Follow-up univariate analyses showed significant decreases in depressive symptoms, F(1, 29) = 23.16, p < .001, η²p = .44, anxiety symptoms, F(1, 29) = 16.90, p < .001, η²p = .37, and negative affect, F(1, 29) = 20.46, p < .001, η²p = .41. Positive affect significantly increased, F(1, 29) = 6.35, p = .017, η²p = .18. These findings suggest that examining rTMS-related clinical change from a multidimensional perspective may contribute to a more comprehensive understanding of treatment response.

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