Unité de Recherche Clinique, Etablissement Public de Santé Ville-Evrard, 202 avenue Jean Jaurès, 93332 Neuilly sur Marne Cedex, France.
Unité de Recherche Clinique, Etablissement Public de Santé Ville-Evrard, 202 avenue Jean Jaurès, 93332 Neuilly sur Marne Cedex, France.
Psychiatry Res. 2017 Dec;258:226-233. doi: 10.1016/j.psychres.2017.08.029. Epub 2017 Aug 18.
A few open-labeled studies have investigated the use of maintenance rTMS to prevent relapse for treatment-resistant depression (TRD) after rTMS treatment. We aim to assess the benefits of maintenance rTMS treatment for TRD patients who respond to rTMS treatment using a randomized, double-blind controlled design. Fifty eight TRD patients received rTMS over one month in an open-labeled design study (phase I). Responder patients were then randomized into active and sham high-frequency rTMS groups for the subsequent eleven months (phase II). The regularity of sessions was gradually reduced. The antidepressant effect of rTMS was evaluated using the Hamilton Depression Rating Scale (HDRS). Intention-to-treat analysis was performed to assess the effectiveness of maintenance sessions. Of the 58 patients included, 35 patients were responders after one month of active rTMS (phase I), and 17 patients were randomized for the maintenance sessions (phase II). The delta HDRS scores demonstrated a significant improvement between the first month and the fourth month in active group in comparison with sham group (phase II). There was no significant difference between these two groups for other periods of time. Repetitive TMS could represent a novel strategy for preventing relapse in TRD patients who respond to rTMS treatment. These results should be confirmed in a larger sample.
一些开放性研究调查了重复经颅磁刺激（rTMS）维持治疗对 rTMS 治疗后难治性抑郁症（TRD）复发的预防作用。我们旨在评估维持 rTMS 治疗对 rTMS 治疗有效的 TRD 患者的益处，采用随机、双盲对照设计。58 例 TRD 患者接受了为期一个月的 rTMS 开放性设计研究（I 期）。对有反应的患者随后在随后的十一个月中被随机分为高频 rTMS 激活组和假刺激组（II 期）。治疗的规律逐渐减少。使用汉密尔顿抑郁评定量表（HDRS）评估 rTMS 的抗抑郁作用。采用意向治疗分析评估维持治疗的效果。在纳入的 58 例患者中，35 例患者在接受一个月的 rTMS 治疗（I 期）后有反应，17 例患者被随机分配进行维持治疗（II 期）。与假刺激组相比，I 期的激活组的 delta HDRS 评分在第一个月和第四个月之间有显著改善。在其他时间段，两组之间没有显著差异。重复经颅磁刺激可能是一种预防 rTMS 治疗有效的 TRD 患者复发的新策略。这些结果应在更大的样本中得到证实。
