Different forms of prefrontal theta burst stimulation for executive function of medication- resistant depression: Evidence from a randomized sham-controlled study
Different forms of prefrontal theta burst stimulation for executive function of medication- resistant depression: Evidence from a randomized sham-controlled study
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DOI：
10.1016/j.pnpbp.2015.11.009
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发表时间：
2016-04-03
影响因子：
5.6
通讯作者：
Li, Cheng-Ta
中科院分区：
文献类型：
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作者：
Cheng, Chih-Ming;Juan, Chi-Hung;Li, Cheng-Ta
背景：即使在症状缓解期间，许多耐药抑郁症(MRD)患者仍表现出认知功能受损，尤其是执行功能(EF)。Theta-Burst经颅磁刺激(TBS)可调节皮质兴奋性，可治疗MRD。以往研究表明，间歇性TBS(ITBS)可产生皮层兴奋效应，而连续TBS(CTBS)可降低皮质兴奋性。EF高度依赖于前额叶活动，但不同形式的额叶TBS对EF的影响尚不清楚。方法：60例MRD患者随机分为4组。治疗由分配给个人的组决定；A：CTBS 1800个脉冲/次；B：ITBS 1800个脉冲/次；C：CTBS+ITBS的组合，每个1800个脉冲/次；D：假TBS。结果：重复单因素方差分析，以治疗前和治疗后2周为受试者因素，显示TBS组(G)与抗抑郁药物反应[(R)，TBS治疗2周后抑郁评分下降50%]对WCST各指标变化(G×R，p<；0.05)的交互作用有统计学意义。B组的应答者，但不是其他组的应答者，显示出WCST表现的显著改善。结论：我们的研究结果表明，左侧额叶ITBS，而不是右侧额叶CTBS，改善了EF，这可能与其抗抑郁作用无关。(C)2015 Elsevier Inc.保留所有权利。
Background: Even during symptomatic remission, many patients with medication resistant depression (MRD) still demonstrate impaired cognitive function, especially executive function (EF). Theta-burst transcranial magnetic stimulation (TBS) modulates cortical excitability and may treat MRD. Evidences from previous studies show that intermittent TBS (iTBS) produces cortical excitatory effects, while continuous TBS (cTBS) produces a reduction of cortical excitability. EF is highly dependent on prefrontal activity, but the effects of different forms of prefrontal TBS on EF remain unknown.Methods: 60 MRD patients were recruited and randomly assigned to one of four groups. Treatment was determined by the group to which an individual was assigned; A: cTBS 1800 pulses/session; B: iTBS 1800 pulses/session; C: a combination of cTBS + iTBS, 1800 pulses/session for each; and D: sham TBS. Wisconsin Card Sorting Test (WCST) for the performance of EF was evaluated before and after 10 daily treatment sessionsResults: Repeated measures ANOVA, with each WCST index at baseline and 2 weeks after TBS as within-subject factors, demonstrated that a statistically significant interaction of TBS groups (G) and antidepressant responses [(R), responses were defined as > 50% reduction of depression scores after 2-weeks TBS treatment] on the before-versus-after changes of all WCST indexes (G x R, p < 0.05). Responders in Group B, but not in the other groups, showed a significant improvement in WCST performance. Only nonresponders in Group A showed a trend for EF worsening.Conclusions: Our findings showed that left prefrontal iTBS, not right prefrontal cTBS, improved EF, and this can be independent from its antidepressant effects. (C) 2015 Elsevier Inc. All rights reserved.