A pilot investigation of an intensive theta burst stimulation protocol for patients with treatment resistant depression
A pilot investigation of an intensive theta burst stimulation protocol for patients with treatment resistant depression
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DOI：
10.1016/j.brs.2019.08.013
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发表时间：
2020-01-01
影响因子：
7.7
通讯作者：
Hoy, Kate E.
中科院分区：
文献类型：
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作者：
Fitzgerald, Paul B.;Chen, Leo;Hoy, Kate E.
简介：加速或强化形式的重复经颅磁刺激（rTMS）越来越多地被探索，因为它们有可能在重度抑郁症（MDD）中产生更有效和快速的治疗益处。然而，使用标准形式的rTMS的加速或密集的协议仍然是相当耗时的应用。Theta爆发刺激（TBS）是一种新型的磁刺激形式，具有产生类似抗癫痫作用的潜力，但时间要短得多。本研究的目的是调查与标准rTMS治疗相比，强化TBS方案的比较疗效。方法：74名门诊病人（36例女性，平均年龄44.36 ± 12.1岁）MDD患者接受强化TBS或（第1周每天3次间歇TBS治疗，持续3天，第2周每天3次治疗，持续2天，第3周和第4周1天3次治疗，或标准rTMS（每周5次，持续4周）。在整个治疗过程中每周对患者进行评估，并在治疗结束后4周进行评估。在抑郁症状减轻程度、抑郁症状减轻率、缓解率或有效率方面无显著差异（强化组的应答率= 27.8%，标准组的应答率= 26.3%，所有分析的p> 0.05）。然而，两组的总体应答率和缓解率均有限。有没有差异率的副作用，没有严重的不良事件和认知performance.Conclusion没有改变：强化应用TBS似乎有类似的疗效标准rTMS时，这些被应用为交付在这项研究中，但不产生更快的临床效益。本研究中两组的总体缓解率有限，最可能是由于两个研究组提供的总剂量。(c)2019爱思唯尔公司这是一个在CC BY-NC-ND许可证下的开放获取文章（http：//creativecommons.org/licenses/by-nc-nd/4.0/）。
Introduction: Accelerated or intensive forms of repetitive transcranial magnetic stimulation (rTMS) are increasingly being explored for their potential to produce more efficient and rapid treatment benefits in major depressive disorder (MDD). However, accelerated or intensive protocols using standard forms of rTMS are still quite time-consuming to apply. Theta burst stimulation (TBS) is a novel form of magnetic stimulation with the potential to produce similar anti-depressant effects but in a much abbreviated period of time. The aim of this study was to investigate the comparative efficacy of an intensive TBS protocol compared to standard rTMS treatment.Methods: 74 outpatients (36 female, mean age 44.36 +/- 12.1 years) with MDD received either intensive TBS (3 intermittent TBS treatments per day for 3 days in week 1, 3 treatments a day for 2 days in week 2, and 3 treatments in 1 day in week 3 and in week 4, or standard rTMS (5 daily sessions per week for 4 weeks). Patients were assessed weekly throughout the treatment course, and at 4 weeks after treatment end.Results: There were no significant differences in the degree of reduction in depressive symptoms, the rate of reduction in depressive symptoms, remission or response rates (response rates = 27.8% for intensive group, 26.3% for the standard group, p > 0.05 for all analyses) between the intensive TBS and standard rTMS treatment groups. However, the overall response and remission rates were limited in both groups. There was no difference in rates of side effects, no serious adverse events and no alterations in cognitive performance.Conclusion: Intensively applied TBS appears to have similar efficacy to standard rTMS when these were applied as delivered in this study but does not produce more rapid clinical benefits. The overall response rates in both groups in this study were limited, most likely by the total doses provided in both study arms. (c) 2019 Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).