Department of Psychiatry, Faculty of Medicine, Saga University, Saga, Japan.
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Neuropsychopharmacol Rep. 2023 Jun;43(2):222-227. doi: 10.1002/npr2.12332. Epub 2023 Mar 12.
Repetitive transcranial magnetic stimulation (rTMS) is one of the most effective and minimally invasive treatments for treatment-resistant depression (TRD). However, the mechanism underlying the therapeutic effects of rTMS in patients with TRD remains unclear. In recent years, the pathogenesis of depression has been closely associated with chronic inflammation and microglia are believed to play an important role in chronic inflammation. Triggering receptor expressed on myeloid cells-2 (TREM2) plays an important role in microglial neuroinflammatory regulation. In this study, we investigated the changes in peripheral soluble TREM2 (sTREM2) before and after rTMS treatment in patients with TRD.
Twenty-six patients with TRD were enrolled in this frequency (10 Hz) rTMS study. Depressive symptoms, cognitive function, and serum sTREM2 concentrations were measured at baseline and the end of the 6-week rTMS treatment.
This study showed that rTMS ameliorated depressive symptoms and partially improved cognitive dysfunction in TRD. However, rTMS treatment did not alter serum sTREM2 levels.
This is the first sTREM2 study in patients with TRD who underwent rTMS treatment. These results suggest that serum sTREM2 may not be relevant for the mechanism underlying the therapeutic effect of rTMS in patients with TRD. Future studies should confirm the present findings using a larger patient sample and a sham rTMS procedure, as well as CSF sTREM2. Furthermore, a longitudinal study should be conducted to clarify the effects of rTMS on sTREM2 levels.
重复经颅磁刺激(rTMS)是治疗难治性抑郁症(TRD)最有效和最微创的治疗方法之一。然而,rTMS 治疗 TRD 患者的疗效机制仍不清楚。近年来,抑郁症的发病机制与慢性炎症密切相关,小胶质细胞被认为在慢性炎症中起重要作用。髓样细胞触发受体-2(TREM2)在小胶质细胞神经炎症调节中发挥重要作用。本研究旨在探讨 TRD 患者 rTMS 治疗前后外周血可溶性 TREM2(sTREM2)的变化。
本研究纳入了 26 例接受频率(10 Hz)rTMS 治疗的 TRD 患者。在基线和 6 周 rTMS 治疗结束时,测量抑郁症状、认知功能和血清 sTREM2 浓度。
本研究表明,rTMS 改善了 TRD 患者的抑郁症状,并部分改善了认知功能障碍。然而,rTMS 治疗并未改变血清 sTREM2 水平。
这是首例接受 rTMS 治疗的 TRD 患者 sTREM2 研究。这些结果表明,血清 sTREM2 可能与 rTMS 治疗 TRD 患者的疗效机制无关。未来的研究应使用更大的患者样本和假 rTMS 程序以及 CSF sTREM2 来证实目前的发现。此外,应进行纵向研究以阐明 rTMS 对 sTREM2 水平的影响。