Department of Neuropsychiatry, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.
Psychiatry Res. 2010 Jan 30;175(1-2):74-7. doi: 10.1016/j.psychres.2008.10.002. Epub 2009 Dec 9.
Hypothalamic-pituitary-thyroid (HPT) axis abnormalities have been reported in some patients with major depression. To knowledge, however, the effects of low-frequency right prefrontal transcranial magnetic stimulation (TMS) on the HPT axis have not yet been elucidated. The goal of this study was to evaluate alterations in the HPT axis associated with the therapeutic efficacy of TMS treatments. Twenty patients with treatment-resistant depression received five 60-s 1-Hz trains over the right dorsolateral prefrontal cortex. Twelve treatment sessions were administered within a 3-week period (total pulses, 3600). Responders were defined as a > or =50% decrease in the Hamilton Depression Rating Scale (HDRS) score. Serum levels of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) were measured, respectively, at pre- and post-treatment. There were no significant changes in fT3 and fT4 levels measured at either pre- or post-treatment in either responders or nonresponders; however, TSH levels of responders elevated significantly after TMS treatments. In addition, there was a significant negative correlation between TSH levels at pretreatment and decrease (%) in the HDRS score. These findings suggest that the HPT axis is associated with antidepressant effects of low-frequency right prefrontal TMS, and indicate that lower TSH levels at pre-treatment are correlated with better therapeutic efficacy.
下丘脑-垂体-甲状腺（HPT）轴异常已在一些重度抑郁症患者中报道。然而，据我们所知，低频右前额叶经颅磁刺激（TMS）对 HPT 轴的影响尚未阐明。本研究旨在评估 TMS 治疗疗效相关的 HPT 轴改变。20 例治疗抵抗性抑郁症患者接受了 5 次 60 秒 1Hz 刺激右背外侧前额叶。在 3 周内给予 12 次治疗（总脉冲数为 3600）。应答者定义为汉密尔顿抑郁评定量表（HDRS）评分下降≥50%。分别在治疗前和治疗后测量血清促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（fT3）和游离甲状腺素（fT4）水平。无论应答者还是无应答者，治疗前和治疗后 fT3 和 fT4 水平均无显著变化；然而，应答者的 TSH 水平在 TMS 治疗后显著升高。此外，治疗前 TSH 水平与 HDRS 评分下降（%）呈显著负相关。这些发现表明 HPT 轴与低频右前额叶 TMS 的抗抑郁作用有关，并表明治疗前较低的 TSH 水平与更好的治疗效果相关。
