Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada.
Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada; Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Harquail Centre for Neuromodulation, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada.
Psychiatry Res. 2023 Nov;329:115525. doi: 10.1016/j.psychres.2023.115525. Epub 2023 Oct 4.
Individuals with major depressive disorder (MDD) may exhibit a seasonal pattern. The impact of a seasonal pattern in depressive symptoms on rTMS outcomes is unexplored. A retrospective analysis was performed on patients with MDD receiving open-label high frequency rTMS to the left dorsolateral prefrontal cortex. Having a seasonal pattern was defined as scoring ≥ 12 on the Personal Inventory for Depression and Seasonal Affective Disorder (PIDS). Primary outcomes included improvement in the Hamilton Depression Rating Scale (HAMD) and remission. Secondary analyses included the use of the self-rated Quick Inventory of Depressive Symptomatology (QIDS) to assess for changes in atypical neurovegetative symptoms. Multiple linear regression, multiple logistic regression, and linear mixed effects analyses were performed. 46 % (58/127) of the sample had a seasonal pattern. Seasonal pattern did not significantly influence improvement in HAMD (PIDS < 12, 7.8, SD 5.9; PIDS ≥ 12, 10.4, SD 4.9 or remission (PIDS < 12, 30 %; PIDS ≥ 12, 34 %). There were equivalent degrees of improvement in atypical neurovegetative symptoms over time as assessed using the QIDS. Depression with seasonal pattern was found to respond to rTMS treatment similarly to depression without seasonal pattern, suggesting that this may be a viable treatment for this group.
患有重度抑郁症(MDD)的个体可能表现出季节性模式。抑郁症状的季节性模式对 rTMS 治疗效果的影响尚未得到探索。对接受左外侧前额叶高频 rTMS 治疗的 MDD 患者进行了回顾性分析。存在季节性模式的定义为个人抑郁和季节性情感障碍量表(PIDS)得分≥12。主要结局包括汉密尔顿抑郁评定量表(HAMD)和缓解的改善。次要分析包括使用自我评定的抑郁症状快速清单(QIDS)评估非典型神经植物症状的变化。进行了多元线性回归、多元逻辑回归和线性混合效应分析。样本中 46%(58/127)的人存在季节性模式。季节性模式对 HAMD 的改善没有显著影响(PIDS<12,7.8,SD 5.9;PIDS≥12,10.4,SD 4.9)或缓解(PIDS<12,30%;PIDS≥12,34%)。使用 QIDS 评估时,非典型神经植物症状随时间的改善程度相当。存在季节性模式的抑郁症对 rTMS 治疗的反应与无季节性模式的抑郁症相似,这表明这可能是此类患者的一种可行治疗方法。