Accelerated intermittent theta burst stimulation treatment in medication-resistant major depression: A fast road to remission?
Accelerated intermittent theta burst stimulation treatment in medication-resistant major depression: A fast road to remission?
复制标题
DOI：
10.1016/j.jad.2016.04.015
复制
发表时间：
2016-08-01
影响因子：
6.6
通讯作者：
Baeken, Chris
中科院分区：
文献类型：
--
作者：
Duprat, Romain;Desmyter, Stefanie;Baeken, Chris
虽然加速重复经颅磁刺激(RTMS)范例和间歇性Theta-Burst刺激(ITBS)可能在难治性抑郁症(TRD)中产生更好的临床结果，但加速ITBS治疗尚未被研究。在这项随机、双盲、假对照、连续四天的交叉研究中，50名TRD患者接受了20次ITBS治疗，应用于左侧背外侧前额叶皮质(DLPFC)。加速的ITBS治疗程序被发现是安全的，无论刺激顺序/类型(真实/虚假)，抑郁症状立即在统计学上显着减少。虽然只有28%的患者在为期两周的程序结束时显示他们的初始汉密尔顿抑郁量表评分下降了50%，但在假控制的ITBS方案结束两周后进行评估时，这一应答率上升到38%，这表明临床效果延迟。重要的是，30%的应答者被认为是临床缓解。我们发现，没有人口统计学因素可以预测人们的反应。我们的研究结果表明，仅对TRD的左侧DLPFC进行四天的加速ITBS治疗可能会在刺激后两周内导致有意义的临床反应。(C)2016爱思唯尔B.V.保留所有权利。
Although accelerated repetitive Transcranial Magnetic Stimulation (rTMS) paradigms and intermittent Theta-burst Stimulation (iTBS) may have the potency to result in superior clinical outcomes in Treatment Resistant Depression (TRD), accelerated iTBS treatment has not yet been studied. In this registered randomized double-blind sham-controlled crossover study, spread over four successive days, 50 TRD patients received 20 iTBS sessions applied to the left dorsolateral prefrontal cortex (DLPFC). The accelerated iTBS treatment procedure was found to be safe and resulted in immediate statistically significant decreases in depressive symptoms regardless of order/type of stimulation (real/sham). While only 28% of the patients showed a 50% reduction of their initial Hamilton Depression Rating Scale score at the end of the two-week procedure, this response rate increased to 38% when assessed two weeks after the end of the sham-controlled iTBS protocol, indicating delayed clinical effects. Importantly, 30% of the responders were considered in clinical remission. We found no demographic predictors for response. Our findings indicate that only four days of accelerated iTBS treatment applied to the left DLPFC in TRD may lead to meaningful clinical responses within two weeks post stimulation. (C) 2016 Elsevier B.V. All rights reserved.