EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, 94010 Créteil, France; Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, 94010 Créteil, France.
Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Ludwig-Maximilian University, 80336 Munich, Germany.
Brain Res. 2018 Nov 15;1699:186-194. doi: 10.1016/j.brainres.2018.08.029. Epub 2018 Aug 30.
Depression and anxiety stand among the most frequent and debilitating complaints in multiple sclerosis (MS) patients. Understanding their neurophysiological correlates might improve their management. To date, no single study has addressed this issue.
Patients completed the Hospital Anxiety and Depression Scale (HADS). Transcranial magnetic stimulation (TMS) was performed to obtain the following corticospinal excitability measures: resting motor threshold, short-interval intracortical inhibition and facilitation, cortical silent period and interhemispheric inhibition (IHI). Anxiety and depression scores were the primary outcomes in the univariate analysis. When obtaining significant associations between anxiety/depression and TMS measures, a multivariate analysis was performed using stepwise linear regression with anxiety and depression scores employed separately as dependent variables and TMS measures, clinical and sociodemographic data as independent variables. Due to the small sample size and the large number of studied variables, only variables with p values <0.05 in the univariate analysis were included in the multivariate analysis.
Fifty patients completed the study (n = 24 women). Their mean age was 51.82 ± 12.72 years. Mean depression score was 6.08 ± 3.66. Mean anxiety score was 5.82 ± 3.42. A significant association was found between anxiety and IHI (p < 0.05), fatigue (p < 0.05), depression (p < 0.05), and female gender (p < 0.05). Stepwise linear regression analysis was performed and IHI values explained 9.10% of variance in anxiety levels (standardized β: 0.31; p < 0.01) when controlling for remaining variables. As for depression, it did not significantly correlate with any TMS measures.
The results highlight the relationship between anxiety and callosal transfer as reflected by IHI values. The current findings are consistent with previous works assessing healthy participants and patients with social anxiety disorders. Compared to MS patients with aberrant callosal transfer (suggested by low IHI values), those exhibiting a relatively more efficient one (reflected by high IHI values) seem to have higher anxiety scores, a finding that merits further assessment.
抑郁和焦虑是多发性硬化症（MS）患者最常见和最具致残性的主诉之一。了解其神经生理学相关性可能有助于改善对其的管理。迄今为止，尚无单一研究涉及该问题。
患者完成了医院焦虑和抑郁量表（HADS）。进行经颅磁刺激（TMS）以获得以下皮质脊髓兴奋性测量值：静息运动阈值、短间隔皮质内抑制和易化、皮质静息期和半球间抑制（IHI）。焦虑和抑郁评分是单变量分析中的主要结果。当在焦虑/抑郁与 TMS 测量之间获得显著关联时，使用逐步线性回归进行多变量分析，将焦虑和抑郁评分分别作为因变量，将 TMS 测量值、临床和社会人口统计学数据作为自变量。由于样本量较小且研究变量较多，仅将单变量分析中 p 值<0.05 的变量纳入多变量分析。
50 名患者完成了研究（n=24 名女性）。他们的平均年龄为 51.82±12.72 岁。平均抑郁评分为 6.08±3.66。平均焦虑评分为 5.82±3.42。焦虑与 IHI（p<0.05）、疲劳（p<0.05）、抑郁（p<0.05）和女性性别（p<0.05）之间存在显著关联。进行逐步线性回归分析，在控制其余变量后，IHI 值解释了焦虑水平变化的 9.10%（标准化β：0.31；p<0.01）。至于抑郁，它与任何 TMS 测量均无显著相关性。
这些结果强调了焦虑与通过 IHI 值反映的胼胝体传递之间的关系。目前的研究结果与评估健康参与者和社交焦虑障碍患者的先前工作一致。与胼胝体传递异常（低 IHI 值提示）的 MS 患者相比，胼胝体传递相对更有效的患者（高 IHI 值提示）似乎具有更高的焦虑评分，这一发现值得进一步评估。
