St Boniface General Hospital, Winnipeg, MB, R2H2A6, Canada.
St Boniface General Hospital, Winnipeg, MB, R2H2A6, Canada; University of Manitoba, Department of Psychiatry, Winnipeg, MB, Canada.
Psychiatry Res. 2019 Sep;279:55-61. doi: 10.1016/j.psychres.2019.07.007. Epub 2019 Jul 4.
Major Depressive Disorder (MDD) is typically accompanied by cognitive impairment. Repetitive Transcranial Magnetic Stimulation (rTMS) treatment for MDD involves stimulation of the dorsolateral prefrontal cortex which plays an important role in cognition. This study aimed to identify differences in cognitive profiles between remitters and non-remitters to rTMS at baseline and across treatment. 25 patients with MDD performed cognitive tasks at baseline and after 6, 12 and 30 sessions of rTMS. At baseline, there was no difference in simple reaction time (RT) between groups, but remitters (n = 13) showed faster RTs than non-remitters (n = 12) in the Switch and No-Switch conditions of Task Switching. Across sessions, remitters showed a decrease in 3-Back omission errors and RTs to 3-Back, Stroop's Congruent and Incongruent, and Task Switching's Switch and No-Switch conditions, whereas non-remitters only showed improvements in Stroop Congruent and Incongruent RTs. Baseline and final scores on the Hamilton Depression Rating Scale were positively correlated with Switch and No-Switch RTs. This study demonstrates that eventual remitters to rTMS treatment for MDD perform better in cognitive tasks requiring shifting attention, and this difference is observable prior to the start of treatment. Remitters also show improvement in both their mood and cognitive performance.
重度抑郁症(MDD)通常伴随着认知障碍。重复经颅磁刺激(rTMS)治疗 MDD 涉及对背外侧前额叶皮层的刺激,该皮层在认知中起着重要作用。本研究旨在确定基线时和治疗过程中缓解者和非缓解者的认知特征差异。25 名 MDD 患者在基线时和 rTMS 治疗 6、12 和 30 次后进行认知任务。在基线时,两组之间的简单反应时间(RT)没有差异,但在任务转换的切换和非切换条件下,缓解者(n=13)的 RT 比非缓解者(n=12)更快。在整个治疗过程中,缓解者的 3 -back 遗漏错误和 3-back、Stroop 的一致和不一致以及任务转换的切换和非切换条件下的 RT 均减少,而非缓解者仅在 Stroop 一致和不一致 RT 上有所改善。汉密尔顿抑郁评定量表的基线和最终评分与切换和非切换 RT 呈正相关。本研究表明,最终对 rTMS 治疗 MDD 有缓解的患者在需要转移注意力的认知任务中表现更好,并且这种差异在治疗开始之前就可以观察到。缓解者的情绪和认知表现也有所改善。