Mayo Clinic Alix School of Medicine, Rochester, Minnesota.
Mayo Clinic Division of Pulmonary and Sleep Medicine, Jacksonville, Florida.
J Clin Sleep Med. 2022 May 1;18(5):1297-1305. doi: 10.5664/jcsm.9846.
It is unknown whether sleep quality improvements after repetitive transcranial magnetic stimulation (rTMS) are inherent to the intervention or related to improvements in depressive symptoms. This retrospective study examined sleep quality in patients with major depressive disorder before and after treatment with rTMS, adjusting for age, sex, sedative-hypnotic use, number of rTMS treatments, depression severity, and changes in depressive symptoms.
Adults with major depressive disorder underwent a 6-week course of 10 Hz rTMS over the left dorsolateral prefrontal cortex. Patients completed the Patient Health Questionnaire-9 depression rating scale and the Pittsburgh Sleep Quality Index before and after treatment. To limit confounding, analysis of depressive symptoms occurred without item 3 (the sleep item) of the Patient Health Questionnaire-9.
Twenty-one patients completed the study, with a mean (± standard deviation) baseline Pittsburgh Sleep Quality Index score of 12.0 (± 3.8), compared to 10.5 (± 4.3) posttreatment ( = .01). The mean baseline Patient Health Questionnaire-9 score without item 3 was 17.3 (± 3.0), compared to 12.2 (± 4.9) posttreatment ( = .0001). Pittsburgh Sleep Quality Index and modified Patient Health Questionnaire-9 changes were uncorrelated in nonadjusted and adjusted linear regression models and in the Spearman rank-order correlation.
Mood and sleep quality improved independently after rTMS treatment, even after adjusting for age, sex, sedative-hypnotic use, number of rTMS treatments, and depression severity. These findings suggest that rTMS exerts direct effects on both mood and sleep in patients with major depressive disorder.
Collins AR, Cheung J, Croarkin PA, Kolla BP, Kung S. Effects of transcranial magnetic stimulation on sleep quality and mood in patients with major depressive disorder. 2022;18(5):1297-1305.
目前尚不清楚经重复经颅磁刺激（rTMS）治疗后睡眠质量的改善是干预本身固有的，还是与抑郁症状的改善有关。本回顾性研究通过调整年龄、性别、镇静催眠药使用、rTMS 治疗次数、抑郁严重程度以及抑郁症状变化等因素，检查了接受 rTMS 治疗前后患有重度抑郁症患者的睡眠质量。
患有重度抑郁症的成年人接受了为期 6 周的 10Hz rTMS 治疗，刺激部位为左侧背外侧前额叶皮质。患者在治疗前后完成了患者健康问卷-9 抑郁量表和匹兹堡睡眠质量指数。为了限制混杂因素，分析抑郁症状时不包括患者健康问卷-9 的第 3 项（睡眠项）。
21 名患者完成了研究，治疗前的匹兹堡睡眠质量指数平均（±标准差）为 12.0（±3.8），治疗后为 10.5（±4.3）（ =.01）。无第 3 项（睡眠项）的患者健康问卷-9 平均基线评分从 17.3（±3.0）降至治疗后的 12.2（±4.9）（ =.0001）。匹兹堡睡眠质量指数和改良患者健康问卷-9 的变化在未调整和调整的线性回归模型以及斯皮尔曼等级相关中均无相关性。
即使在调整年龄、性别、镇静催眠药使用、rTMS 治疗次数和抑郁严重程度后，rTMS 治疗后情绪和睡眠质量仍独立改善。这些发现表明，rTMS 对重度抑郁症患者的情绪和睡眠均有直接影响。
Collins AR, Cheung J, Croarkin PA, Kolla BP, Kung S. Effects of transcranial magnetic stimulation on sleep quality and mood in patients with major depressive disorder. 2022;18(5):1297-1305.
