Duprat Romain, Desmyter Stefanie, Rudi De Raedt, van Heeringen Kees, Van den Abbeele Dirk, Tandt Hannelore, Bakic Jasmina, Pourtois Gilles, Dedoncker Josefien, Vervaet Myriam, Van Autreve Sara, Lemmens Gilbert M D, Baeken Chris
Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium.
Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium.
J Affect Disord. 2016 Aug;200:6-14. doi: 10.1016/j.jad.2016.04.015. Epub 2016 Apr 19.
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.
尽管加速重复经颅磁刺激（rTMS）模式和间歇性θ波爆发刺激（iTBS）可能有潜力在难治性抑郁症（TRD）中产生更好的临床效果，但加速iTBS治疗尚未得到研究。在这项注册的随机双盲假对照交叉研究中，50名TRD患者在连续四天内接受了20次应用于左侧背外侧前额叶皮质（DLPFC）的iTBS治疗。结果发现，加速iTBS治疗程序是安全的，并且无论刺激顺序/类型（真实/假）如何，都能立即在统计学上显著降低抑郁症状。虽然在两周疗程结束时只有28%的患者汉密尔顿抑郁量表初始评分降低了50%，但在假对照iTBS方案结束两周后进行评估时，这一缓解率提高到了38%，表明存在延迟的临床效果。重要的是，30%的缓解者被认为处于临床缓解状态。我们没有发现反应的人口统计学预测因素。我们的研究结果表明，在TRD患者中，仅对左侧DLPFC进行四天的加速iTBS治疗可能会在刺激后两周内产生有意义的临床反应。
