A randomized sham controlled comparison of once vs twice-daily intermittent theta burst stimulation in depression: A Canadian rTMS treatment and biomarker network in depression (CARTBIND) study
A randomized sham controlled comparison of once vs twice-daily intermittent theta burst stimulation in depression: A Canadian rTMS treatment and biomarker network in depression (CARTBIND) study
复制标题
DOI：
10.1016/j.brs.2021.09.003
复制
发表时间：
2021-09-30
影响因子：
7.7
通讯作者：
Downar, Jonathan
中科院分区：
文献类型：
--
作者：
Blumberger, Daniel M.;Vila-Rodriguez, Fidel;Downar, Jonathan
背景：间歇性θ爆发刺激（iTBS）是针对难治性抑郁症（TRD）患者的一种新型重复经颅磁刺激（rTMS）。每天进行多次 iTBS 治疗可能使患者更快地获得缓解。目的：我们比较了 TRD 患者每日两次与每日一次 iTBS 方案的疗效和耐受性。我们假设，与每天一次 iTBS 相比，每天两次 iTBS 会带来更大的抑郁评分改善。方法：208 名患有 TRD 的参与者（131 名女性）被随机分配接受每天两次 iTBS（600 次脉冲）治疗，治疗间隔 54 分钟，或每天一次（1200 次脉冲）接受 1 次假治疗，治疗间隔相同，以确保每日治疗接触水平相同，并对患者和评估者进行盲法。主要结果指标是治疗 10 天和治疗 30 天后汉密尔顿抑郁量表 (HRSD-17) 抑郁评分的变化。结果：每日两次和每日一次 iTBS 组的 HRSD-17 分数均有所提高；然而，无论是在 10 天还是 30 天的时间点，两组的这些改善并没有显着差异。缓解率和缓解率较低（
Background: Intermittent theta burst stimulation (iTBS) is a newer form of repetitive transcranial magnetic stimulation (rTMS) for patients with treatment resistant depression (TRD). Applying multiple daily iTBS sessions may enable patients to achieve remission more rapidly. Objective: We compared the efficacy and tolerability of a twice-daily versus once-daily iTBS protocol in patients with TRD. We hypothesized that twice-daily iTBS would result in a greater improvement in depression scores compared to once-daily iTBS. Methods: 208 participants (131 females) with TRD were randomized to receive either iTBS (600 pulses) delivered twice-daily with a 54-min interval between treatments or once-daily (1200 pulses) with 1 sham treatment with the same interval between treatments, to ensure equal levels of daily therapeutic contact and blinding of patients and raters. The primary outcome measure was change in depression scores on the Hamilton Rating Scale for Depression (HRSD-17) after 10 days of treatment and 30 days of treatments. Results: HRSD-17 scores improved in both the twice-daily and once-daily iTBS groups; however, these improvements did not significantly differ between the two groups at either the 10-day or 30-day timepoints. Response and remission rates were low (