Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000, Nantes, France.
Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000, Nantes, France.
J Psychiatr Res. 2024 May;173:309-316. doi: 10.1016/j.jpsychires.2024.03.050. Epub 2024 Mar 29.
Psychomotor retardation is a core clinical component of Major Depressive Disorder responsible for disability and is known as a treatment response marker of biological treatments for depression. Our objective was to describe cognitive and motoric measures changes during a treatment by repetitive Transcranial Magnetic Stimulation (rTMS) within the THETAD-DEP trial for treatment-resistant depression (TRD), and compare those performances at the end of treatment and one month after between responders (>50% improvement on MADRS score), partial responders (25-50%) and non-reponders (no clinically relevant improvement). Our secondary aim was to investigate baseline psychomotor performances associated with non-response and response even partial.
Fifty-four patients with treatment-resistant unipolar depression and treated by either high frequency 10 Hz rTMS or iTBS for 4 weeks (20 sessions) underwent assessment including French Retardation Rating Scale for Depression (ERD), Verbal Fluency test, and Trail Making Test A. before, just after treatment and one month later.
20 patients were responders (R, 21 partial responders (PR) and 13 non-responders (NR). rTMS treatment improved psychomotor performances in the R and PR groups unlike NR patients whose psychomotor performance was not enhanced by treatment. At baseline, participants, later identified as partial responders, showed significantly higher performances than non-responders.
Higher cognitivo-motor performances at baseline may be associated with clinical improvement after rTMS treatment. This work highlights the value of objective psychomotor testing for the identification of rTMS responders and partial responders, and thus may be useful for patient selection and protocol individualization such as treatment continuation for early partial responders.
精神运动迟缓是导致抑郁致残的重性抑郁障碍的核心临床特征，也是抗抑郁生物治疗的应答标志物。本研究旨在描述重复经颅磁刺激（rTMS）治疗难治性抑郁症（TRD）的治疗过程中的认知和运动变化，并比较治疗结束时和治疗结束后一个月应答者（MADRS 评分改善>50%）、部分应答者（25-50%）和无应答者（无临床相关改善）之间的表现。本研究的次要目的是调查与无应答和部分应答（甚至部分应答）相关的基线精神运动表现。
54 例单相抑郁、TRD 患者接受高频（10 Hz）rTMS 或 iTBS 治疗 4 周（20 次），在治疗前、治疗结束时和治疗结束后 1 个月进行评估，包括法国抑郁延缓评定量表（ERD）、言语流畅性测试和连线测试 A。
20 例患者为应答者（R），21 例为部分应答者（PR），13 例为无应答者（NR）。与 NR 患者不同，rTMS 治疗改善了 R 和 PR 组的精神运动表现，而 NR 患者的精神运动表现并未因治疗而改善。在基线时，后来被确定为部分应答者的参与者表现出明显高于无应答者的表现。
基线时较高的认知-运动表现可能与 rTMS 治疗后的临床改善有关。这项工作强调了客观精神运动测试在识别 rTMS 应答者和部分应答者中的价值，因此可能有助于患者选择和方案个体化，如对早期部分应答者继续治疗。
