1The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing,China.
2Department of Psychiatry,The Zucker Hillside Hospital,Northwell Health,Glen Oaks,New York,United States.
CNS Spectr. 2019 Jun;24(3):313-321. doi: 10.1017/S1092852917000670. Epub 2018 Feb 20.
Low-field magnetic stimulation (LFMS) has mood-elevating effect, and the increase of brain-derived neurotrophic factor (BDNF) is associated with antidepressant treatment. We evaluated the effects and association with BDNF of rhythmic LFMS in the treatment of major depressive disorder (MDD).
A total of 22 MDD patients were randomized to rhythmic alpha stimulation (RAS) or rhythmic delta stimulation (RDS), with 5 sessions per week, lasting for 6 weeks. Outcomes assessments included the 17-item Hamilton Depression Rating Scale (HAMD-17), the Hamilton Anxiety Rating Scale (HAMA), and the Clinical Global Impressions-Severity scale (CGI-S) at baseline and at weeks 1, 2, 3, 4, and 6. Serum BDNF level was measured at baseline and at weeks 2, 4, and 6.
HAMD-17, HAMA, and CGI-S scores were significantly reduced with both RAS and RDS. RAS patients had numerically greater reductions in HAMD-17 scores than RDS patients (8.9 ± 7.4 vs. 6.2 ± 6.2, effect size [ES]=0.40), while RDS patients had greater improvement in HAMA scores (8.2 ± 8.0 vs. 5.3 ± 5.8, ES=0.42). RAS was associated with clinically relevant advantages in response (54.5% vs. 18.2%, number-needed-to-treat [NNT]=3) and remission (36.4% vs. 9.1%, NNT=4). BDNF increased significantly during the 6-week study period (p<0.05), with greater increases in RAS at weeks 4 and 6 (ES=0.66-0.76) and statistical superiority at week 2 (p=0.034, ES=1.23). Baseline BDNF in the 8 responders (24.8±9.0 ng/ml) was lower than in the 14 nonresponders (31.1±7.3 ng/ml, p=0.083, ES=-0.79), and BDNF increased more in responders (8.9±7.8 ng/ml) than in nonresponders (1.8±3.5 ng/ml, p=0.044). The change in BDNF at week 2 was the most strongly predicted response (p=0.016).
Rhythmic LFMS was effective for MDD. BDNF may moderate/mediate the efficacy of LFMS.
低频磁场刺激（LFMS）具有改善情绪的作用，而脑源性神经营养因子（BDNF）的增加与抗抑郁治疗有关。我们评估了节律性 LFMS 对重度抑郁症（MDD）的治疗效果及其与 BDNF 的相关性。
共 22 例 MDD 患者随机分为节律性阿尔法刺激（RAS）或节律性德尔塔刺激（RDS）组，每周 5 次，持续 6 周。疗效评估包括基线时和第 1、2、3、4、6 周的 17 项汉密尔顿抑郁量表（HAMD-17）、汉密尔顿焦虑量表（HAMA）和临床总体印象严重程度量表（CGI-S）。在基线和第 2、4、6 周测量血清 BDNF 水平。
RAS 和 RDS 均可显著降低 HAMD-17、HAMA 和 CGI-S 评分。与 RDS 组相比，RAS 组 HAMD-17 评分的降低更显著（8.9±7.4 分比 6.2±6.2 分，效应量[ES]=0.40），而 RDS 组 HAMA 评分的改善更显著（8.2±8.0 分比 5.3±5.8 分，ES=0.42）。RAS 组在反应（54.5%比 18.2%，需要治疗的人数[NNT]=3）和缓解（36.4%比 9.1%，NNT=4）方面具有临床相关优势。BDNF 在研究期间（p＜0.05）呈显著升高趋势，RAS 在第 4 周和第 6 周时升高更显著（ES=0.66-0.76），第 2 周时具有统计学优势（p=0.034，ES=1.23）。8 名反应者（24.8±9.0ng/ml）的基线 BDNF 低于 14 名无反应者（31.1±7.3ng/ml，p=0.083，ES=-0.79），反应者的 BDNF 增加更显著（8.9±7.8ng/ml）比无反应者（1.8±3.5ng/ml，p=0.044）。第 2 周 BDNF 的变化是反应的最强预测指标（p=0.016）。
节律性 LFMS 对 MDD 有效。BDNF 可能调节/介导 LFMS 的疗效。
