Li Cheng-Ta, Cheng Chih-Ming, Lin Hui-Ching, Yeh Skye Hsin-Hsieh, Jeng Jia-Shyun, Wu Hui-Ting, Bai Ya-Mei, Tsai Shih-Jen, Su Tung-Ping, Fitzgerald Paul B
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan; Institute of Brain Science and Brain Research Center, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan; Institute of Cognitive Neuroscience, National Central University, Jhongli, Taiwan; School of Medicine, National Defense Medical Center, Taipei, Taiwan.
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan; Institute of Brain Science and Brain Research Center, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan; School of Medicine, National Defense Medical Center, Taipei, Taiwan.
Asian J Psychiatr. 2023 Sep;87:103686. doi: 10.1016/j.ajp.2023.103686. Epub 2023 Jun 26.
BACKGROUND: Prolonged intermittent theta-burst stimulation (iTBS) is effective for major depressive disorder (MDD). However, whether longer piTBS treatment in a single session could have antidepressant efficacy remains elusive. Therefore, this double-blind, randomized, sham-controlled study aimed to investigate the antidepressant efficacy of 2 daily piTBS sessions for treating MDD patients with a history of poor responses to at least 1 adequate antidepressant trial in the current episode. METHODS: All patients received 2 uninterrupted sessions per day for 10 weekdays (i.e., 2 weeks; a total of 20 sessions). Seventy-two patients were recruited and 1:1:1 randomly assigned to one of three groups: piTBS (piTBSx2), 10-Hz rTMS (rTMSx2), or sham treatment (shamx2, randomly assigned to piTBS or rTMS). 10-Hz rTMS group was included as an active comparison group to enhance assay sensitivity. RESULTS: piTBSx2 group had significantly more responders at week 2 than shamx2 group, but it did not yield better antidepressant effects regarding the %depression changes. The changes of antidepressant scores were not different among the three groups at week 1 (-26.2% vs. -23.3% vs. -22.%) or at week 2 (-34.1% vs. -37.1% vs. -30.1%). Longer treatment duration did not result in stronger placebo effects [sham(piTBS)x2: - 31.7% vs. sham(rTMS)x2: - 26.7%]. CONCLUSION: The present sham-controlled study confirmed that piTBS is an effective antidepressant option, but found no evidence to support that longer piTBS treatment duration resulted in more rapid or better antidepressant effects. A high placebo effect was observed, but longer treatment duration of brain stimulation was not linearly associated with stronger placebo effects.
背景：长时间间歇性θ波爆发刺激（iTBS）对重度抑郁症（MDD）有效。然而，单次治疗中更长时间的piTBS治疗是否具有抗抑郁疗效仍不明确。因此，这项双盲、随机、假刺激对照研究旨在调查每日两次piTBS治疗对当前发作中至少对1次充分抗抑郁试验反应不佳的MDD患者的抗抑郁疗效。 方法：所有患者在10个工作日内每天接受2次不间断治疗（即2周；共20次）。招募了72名患者，并将其按1:1:1随机分为三组之一：piTBS（piTBSx2）、10赫兹重复经颅磁刺激（rTMSx2）或假刺激治疗（shamx2，随机分配为piTBS或rTMS）。纳入10赫兹rTMS组作为活性对照组以提高检测灵敏度。 结果：piTBSx2组在第2周时的反应者明显多于shamx2组，但在抑郁变化百分比方面并未产生更好的抗抑郁效果。三组在第1周（-26.2%对-23.3%对-22%）或第2周（-34.1%对-37.1%对-30.1%）时抗抑郁评分的变化并无差异。更长的治疗持续时间并未导致更强的安慰剂效应[假刺激（piTBS）x2：-31.7%对假刺激（rTMS）x2：-26.7%]。 结论：本项假刺激对照研究证实piTBS是一种有效的抗抑郁选择，但没有证据支持更长的piTBS治疗持续时间会带来更快或更好的抗抑郁效果。观察到较高的安慰剂效应，但脑刺激的更长治疗持续时间与更强的安慰剂效应并非线性相关。
Eur Arch Psychiatry Clin Neurosci. 2023-10
Chronic Stress (Thousand Oaks). 2021-4-8
Acta Psychiatr Scand. 2025-4
Zotero 插件