Poulet E, Galvao F, Haffen E, Szekely D, Brault C, Haesebaert F, Brunelin J
Inserm, U1028, CNRS, UMR5292, Lyon neuroscience research center, ΨR2 Team, université de Lyon, 69000 Lyon, France; University Lyon 1, 69000 Villeurbanne, France; Centre hospitalier Le Vinatier, 69678 Bron, France; Service de psychiatrie des urgences, hôpital Édouard-Herriot, CHU de Lyon, 69000 Lyon, France.
Inserm, U1028, CNRS, UMR5292, Lyon neuroscience research center, ΨR2 Team, université de Lyon, 69000 Lyon, France; University Lyon 1, 69000 Villeurbanne, France; Centre hospitalier Le Vinatier, 69678 Bron, France.
Eur Psychiatry. 2016 Oct;38:40-44. doi: 10.1016/j.eurpsy.2016.04.004. Epub 2016 Sep 19.
Despite growing evidence supporting the clinical interest of repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant depression (TRD), little is known regarding the effects of clinical and sociodemographic factors on the clinical outcome in patients.
We retrospectively investigated the effects of clinical (using the 3-factor model of the Montgomery-Åsberg depression rating scale [MADRS] encompassing dysphoria, retardation and vegetative symptoms) and sociodemographic characteristics of participants on clinical outcome in a sample of 54 TRD patients receiving low frequency rTMS (1Hz, 360 pulses) applied over the right dorsolateral prefrontal cortex combined with sham venlafaxine.
Responders (n=29) displayed lower retardation baseline scores (13.6±2.9) than non-responders (15.6±2.9; n=25; P=0.02). We also observed a significant difference between the numbers of ex-smokers in responders and non-responders groups; all ex-smokers (n=8) were responders to rTMS (P=0.005).
Low MADRS retardation factor and ex-smoker status is highly prevalent in responders to low frequency rTMS. Further studies are needed to investigate the predictive value of these factors.
尽管越来越多的证据支持重复经颅磁刺激（rTMS）在难治性抑郁症（TRD）治疗中的临床应用价值，但对于临床和社会人口学因素对患者临床结局的影响知之甚少。
我们回顾性研究了54例接受右侧背外侧前额叶皮质低频rTMS（1Hz，360次脉冲）联合安慰剂文拉法辛治疗的TRD患者的临床（采用蒙哥马利-阿斯伯格抑郁量表[MADRS]的三因素模型，包括烦躁不安、迟缓及躯体症状）和社会人口学特征对临床结局的影响。
应答者（n=29）的迟缓基线评分（13.6±2.9）低于无应答者（15.6±2.9；n=25；P=0.02）。我们还观察到应答者组和无应答者组中戒烟者数量存在显著差异；所有戒烟者（n=8）均对rTMS有应答（P=0.005）。
低频rTMS应答者中MADRS迟缓因子得分低及戒烟状态的情况很常见。需要进一步研究来探讨这些因素的预测价值。
