A single session of rTMS over the left dorsolateral prefrontal cortex influences attentional control in depressed patients.

Depressed patients are impaired in the ability to shift their focus of attention. This attentional control process is related to dysfunctions in the dorsolateral prefrontal cortex (DLPFC). It has been proposed that a dorsal circuit plays an important role in the interaction between emotional and attentional information processing. However, because the different emphasis of fundamental cognitive neuroscience research and clinical research of repetitive transcranial magnetic stimulation (rTMS) over the DLPFC, little research has been done on the effects of rTMS on cognitive functioning after a single stimulation session to explore the neural systems underlying depression. This study was conducted as a double-blind, placebo-controlled, crossover, within subjects design. Sixteen depressed patients performed a modified task switching paradigm, before and after receiving high frequency (HF) versus placebo rTMS over the left DLPFC. One session of HF-rTMS over the left DLPFC had a specific beneficial effect on task-switching performance, whereas mood remained stable. Antidepressant effects of rTMS could be related to the same neurochemical changes that underlie cognitive functioning. Therefore, task switching performance may provide a unique window into the extent of antidepressant effects which can be considered as second-order long-term effects possibly related to primary alternations in cognitive functioning.