Repetitive Transcranial Magnetic Stimulation (rTMS) therapy to improve symptoms in Dysthymia patients: a case report

Introduction: Dysthymia, or persistent depressive disorder (PDD), is a state of chronic depressive mood that currently does not meet the criteria for depressive disorder and occurs all the time or persists for at least 2 years. Management of dysthymia is a combination of antidepressants and psychotherapy. Transcranial magnetic stimulation (TMS) is referred to as adjuvant therapy for depression. However, there have been no studies that specifically provide TMS for dysthymia.Case Presentation: A 27-year-old male, came to the Psychiatric Poly of regional mental hospital with complaints of not having the spirit of life for 8 years. The total Beck Depression Inventory (BDI) score starts at 10. This patient received rTMS 20 times with a frequency of 5 Hz, a motor threshold of 60%, and the dorsolateral prefrontal left cortex (DLPFC) improved, as evidenced by the BDI score being 4.Discussion: Dysthymia conditions affect neuron cells and make them less active, so neurotransmitter instability is not achieved, especially with serotonin, norepinephrine, and dopamine. So, it can provide stimulation to reactivate neuron cells and help neurotransmitters reach their balance point. This patient has been given 20 rTMS. The reason for giving a frequency of 5 Hz is because a high frequency is excitatory, so it can provide stimulation to activate neuron cells again. The location at DLPFC is because it adapts to previous research that the location has been linked to depressive states and plays a role in a person's executive function. Stimulation using motor threshold is 60% because it is the average human intensity.Conclusion: rTMS is effective for improving the symptoms of patients with dysthymia