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重复经颅磁刺激治疗缓解老年人抑郁症和执行功能障碍:一项开放标签研究。

iTBS to Relieve Depression and Executive Dysfunction in Older Adults: An Open Label Study.

作者信息

Cristancho Pilar, Kamel Lojine, Araque Manuela, Berger Jacinda, Blumberger Daniel M, Miller J Philip, Barch Deanna M, Lenze Eric J

机构信息

Department of Psychiatry, Healthy Mind Lab, School of Medicine, Washington University in St. Louis (PC, LK, MA, JB, EJL), St. Louis MO.

Department of Psychiatry, Healthy Mind Lab, School of Medicine, Washington University in St. Louis (PC, LK, MA, JB, EJL), St. Louis MO.

出版信息

Am J Geriatr Psychiatry. 2020 Nov;28(11):1195-1199. doi: 10.1016/j.jagp.2020.03.001. Epub 2020 Mar 8.

Abstract

BACKGROUND

Executive Function Deficits (EFD) accompany depression and are associated with poor outcomes in older adults. We examined whether Intermittent Theta Burst Stimulation (iTBS) could improve depression with EFD.

METHODS

Thirteen geriatric patients with depression and EFD were enrolled. Open label iTBS was delivered bilaterally over the dorso-lateral-prefrontal-cortex for four weeks.

RESULTS

Montgomery Asberg Depression Scale scores improved significantly from baseline to treatment-end, mean change in score = 11.82 points, 95% CI = 8.3, 15.4. The Flanker Inhibitory control and attention test showed significant improvement in executive function from baseline to treatment-end, mean change in score = -7.73, 95% CI ( -13.54, -1.92). Side effects included twitching in facial muscles (n = 11), headaches (n = 10) and stimulation discomfort (n = 4).

LIMITATIONS

Small sample size and lack of a sham comparator.

CONCLUSION

iTBS improved depression with EFD in older adults. Side effects appeared higher than in previous iTBS studies.

摘要

背景

执行功能缺陷(EFD)与抑郁症相伴,且在老年人中与不良预后相关。我们研究了间歇性theta爆发刺激(iTBS)是否能改善伴有EFD的抑郁症。

方法

招募了13名患有抑郁症和EFD的老年患者。对双侧背外侧前额叶皮质进行开放标签iTBS治疗,为期四周。

结果

蒙哥马利-艾斯伯格抑郁量表评分从基线到治疗结束有显著改善,评分平均变化=11.82分,95%置信区间=8.3,15.4。侧翼抑制控制和注意力测试显示,从基线到治疗结束,执行功能有显著改善,评分平均变化=-7.73,95%置信区间(-13.54,-1.92)。副作用包括面部肌肉抽搐(n=11)、头痛(n=10)和刺激不适(n=4)。

局限性

样本量小且缺乏假对照。

结论

iTBS改善了老年人伴有EFD的抑郁症。副作用似乎比之前的iTBS研究中更高。

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