The term vascular depression has been used to describe late-life depressive disorders in patients with evidence of cerebrovascular disease. Some studies have suggested that vascular depression is more long-lasting and more resistant to treatment than early-onset depression. Transcranial magnetic stimulation (TMS), in which powerful magnets are moved back and forth over the skull, has been proved to have an antidepressant effect in some studies but little research has been done on its effectiveness in treating older people or those with cerebrovascular problems. Researchers in Iowa studied 92 patients with vascular depression giving one group TMS and the other a sham treatment. In a second experiment the dose of TMS was increased without telling the patients. This was important as it is quite hard to produce a realistic 'sham' treatment for TMS. The researchers hoped that a higher dose of TMS would produce more positive results which were definitely down to the treatment rather than just positive thinking. In both experiments TMS proved far superior to a sham treatment and the higher dose turned out to be more effective than a lower one.
Jorge, Ricardo E. ... [et al] - Treatment of vascular depression using repetitive transcranial magnetic stimulation Archives of General Psychiatry March 2008, 65(3), 268-276