Jin Xin, Xu Chun-Yun, Fei Jin-Feng, Fang Yu, Sun Cong-Hao
Department of Psychiatry, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China.
World J Psychiatry. 2024 Aug 19;14(8):1216-1223. doi: 10.5498/wjp.v14.i8.1216.
Alzheimer's disease (AD), characterized by the ongoing deterioration of neural function, often presents alongside depressive features and greatly affects the quality of life of individuals living with the condition. Although several treatment methods exist, their efficacy is limited. In recent years, repetitive transcranial magnetic stimulation (rTMS) utilizing the theta burst stimulation (TBS) mode, specifically the intermittent TBS (iTBS), has demonstrated promising therapeutic potential in the management of neuropsychiatric disorders.
To examine the therapeutic efficacy of iTBS mode of rTMS for treating depressive symptoms in patients with AD.
This retrospective study enrolled 105 individuals diagnosed with AD with depressive symptoms at Huzhou Third Municipal Hospital, affiliated with Huzhou University, between January 2020 and December 2023. Participants received standard pharmacological interventions and were categorized into control ( = 53) and observation ( = 52) groups based on treatment protocols. The observation group received iTBS mode of rTMS, while the control group received pseudo-stimulation. A comparative analysis evaluated psychological well-being, adverse events, and therapeutic at initiation of hospitalization (T0) and 15 days post-treatment (T1).
At T1, both groups exhibited a marked reduction in self-rating depression scale and Hamilton depression scale scores compared to T0. Furthermore, the observation group showed a more pronounced decrease than the control group. By T1, the Mini-mental state examination scores for both groups had increased markedly from their initial T0 assessments. Importantly, the increase was particularly more substantial in the observation group than in the control group. Fourteen patients in the control group had ineffective treatment effects, while five patients in the observation group experienced the same. Additionally, the observation group experienced a substantially reduced incidence of ineffective treatment as compared to the control group (both < 0.05); there were no recorded serious adverse events in either group.
The iTBS model of rTMS effectively treated AD with depression, improving depressive symptoms and cognitive function in patients without serious adverse reactions, warranting clinical consideration.
阿尔茨海默病（AD）以神经功能持续恶化为特征，常伴有抑郁症状，严重影响患者的生活质量。尽管现有多种治疗方法，但其疗效有限。近年来，采用theta爆发刺激（TBS）模式的重复经颅磁刺激（rTMS），特别是间歇性TBS（iTBS），在神经精神疾病的治疗中显示出了有前景的治疗潜力。
探讨rTMS的iTBS模式治疗AD患者抑郁症状的疗效。
本回顾性研究纳入了2020年1月至2023年12月期间在湖州师范学院附属湖州市第三人民医院诊断为伴有抑郁症状的AD患者105例。参与者接受标准药物干预，并根据治疗方案分为对照组（n = 53）和观察组（n = 52）。观察组接受rTMS的iTBS模式，而对照组接受伪刺激。通过比较分析评估住院开始时（T0）和治疗后15天（T1）的心理健康状况、不良事件和治疗效果。
在T1时，与T0相比，两组的自评抑郁量表和汉密尔顿抑郁量表评分均显著降低。此外，观察组的下降更为明显。到T1时，两组的简易精神状态检查表评分均较初始T0评估显著提高。重要的是，观察组的提高尤其比对照组更显著。对照组有14例患者治疗效果不佳，观察组有5例患者治疗效果不佳。此外，与对照组相比，观察组治疗无效的发生率显著降低（均P < 0.05）；两组均未记录到严重不良事件。
rTMS的iTBS模式有效治疗了伴有抑郁的AD，改善了患者的抑郁症状和认知功能，且无严重不良反应，值得临床考虑。
