Department of Neurology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, China.
Medicine (Baltimore). 2023 Sep 1;102(35):e34841. doi: 10.1097/MD.0000000000034841.
Studies have reported the use of repetitive transcranial magnetic stimulation (rTMS) in patients with major depressive disorder (MDD). However, most studies focus on antidepressant effect of rTMS, but few on cognitive aspects. The present study aimed to explore the effect of rTMS on BDNF levels and cognitive function in the treatment of middle-aged and elderly MDD.
This was a randomized controlled trial. A total of 120 elderly patients with MDD treated in The Second Affiliated Hospital of Xi'an Medical University from January 2021 to January 2023 were selected as research subjects. The patients were randomly divided into control group (n = 60, patients received simple oral treatment with escitalopram and sham rTMS) and study group (n = 60, patients received oral treatment with escitalopram combined with rTMS) according to the random number table method. We compared the clinical efficacy, serum BDNF levels, and cognitive function between the 2 groups.
After treatment, the HAMD-17 score in the study group was lower than that in the control group [13.00 (12.00-16.00) vs 17.00 (15.00-19.00), P < .05], and the RBANS score was higher than that in the control group [166.00 (161.25-171.75) vs 133.00 (130.00-136.75), P < .05]. The total effective rate of the research group was 95.0%, which was higher than the 82.0% of the control group (P < .05). The serum BDNF levels [36.00 (33.00-38.00) vs 30.00 (28.00-32.00), P < .05] and MoCA scores [24.00 (22.00-26.75) vs 23.00 (21.00-25.00), P < .05] of the study group were higher than those of the control group. There were no significant adverse reactions during the treatment of both groups.
Compared with oral escitalopram alone, repeated transcranial magnetic stimulation in the treatment of middle-aged and elderly patients with major depressive disorder can further improve the efficacy, and can more effectively improve the BDNF level and cognitive function, with ideal safety.
研究报告称，重复经颅磁刺激（rTMS）可用于治疗重度抑郁症（MDD）患者。然而，大多数研究都集中在 rTMS 的抗抑郁作用上，而很少关注认知方面。本研究旨在探讨 rTMS 对中老年 MDD 患者 BDNF 水平和认知功能的治疗作用。
这是一项随机对照试验。选取 2021 年 1 月至 2023 年 1 月在西安医学院第二附属医院治疗的 120 例中老年 MDD 患者为研究对象。采用随机数字表法将患者分为对照组（n=60，患者接受艾司西酞普兰单纯口服治疗和假 rTMS）和观察组（n=60，患者接受艾司西酞普兰联合 rTMS 口服治疗）。比较两组的临床疗效、血清 BDNF 水平和认知功能。
治疗后，观察组 HAMD-17 评分低于对照组[13.00（12.00-16.00）比 17.00（15.00-19.00），P<0.05]，RBANS 评分高于对照组[166.00（161.25-171.75）比 133.00（130.00-136.75），P<0.05]。观察组总有效率为 95.0%，高于对照组的 82.0%（P<0.05）。观察组血清 BDNF 水平[36.00（33.00-38.00）比 30.00（28.00-32.00），P<0.05]和 MoCA 评分[24.00（22.00-26.75）比 23.00（21.00-25.00），P<0.05]均高于对照组。两组治疗期间均无明显不良反应。
与单纯口服艾司西酞普兰相比，重复经颅磁刺激治疗中老年 MDD 患者可进一步提高疗效，更有效改善 BDNF 水平和认知功能，安全性理想。
