Prodi Tiziano, Pezzullo Gabriele, La Monica Kevin, Priori Alberto, Vismara Matteo, Dell'Osso Bernardo, Benatti Beatrice
Department of Psychiatry, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy.
"Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, 20122 Milan, Italy.
Brain Sci. 2024 Sep 22;14(9):949. doi: 10.3390/brainsci14090949.
BACKGROUND/OBJECTIVES: In the past two decades, significant advancements in neuromodulation techniques have occurred, such as transcranial magnetic stimulation (TMS) for treatment-resistant depression (TRD). According to the assumption that repeated stimulation within a condensed timeframe can yield sustained efficacy, an accelerated protocol may be more effective in reducing time to response. With those premises, this study aimed to evaluate a sample of TRD patients treated with standard repetitive TMS (rTMS) and accelerated rTMS (arTMS).
Nine subjects were treated with standard rTMS and 19 with arTMS. Psychometric assessment was made at the baseline and one week, one month, and three months after the treatment. A linear mixed-effect regression was performed along with other appropriate statistical analyses.
A significant improvement over time was observed for both depressive and cognitive symptoms. Moreover, considering the reduction in the Montgomery-Asberg Depression Rating Scale scores, a better treatment response was observed in subjects treated with arTMS ( < 0.05).
Our findings showed a significant difference between the two protocols in terms of clinical response. Although further studies are needed to confirm the superiority of arTMS, the better cost-effectiveness of this technique should be considered.
背景/目的:在过去二十年中,神经调节技术取得了重大进展,例如用于治疗难治性抑郁症(TRD)的经颅磁刺激(TMS)。根据在紧凑时间框架内重复刺激可产生持续疗效的假设,加速方案可能在缩短起效时间方面更有效。基于这些前提,本研究旨在评估一组接受标准重复经颅磁刺激(rTMS)和加速rTMS(arTMS)治疗的TRD患者样本。
9名受试者接受标准rTMS治疗,19名接受arTMS治疗。在基线以及治疗后1周、1个月和3个月进行心理测量评估。进行了线性混合效应回归以及其他适当的统计分析。
抑郁和认知症状均随时间有显著改善。此外,考虑到蒙哥马利-阿斯伯格抑郁评定量表评分的降低,接受arTMS治疗的受试者表现出更好的治疗反应(<0.05)。
我们的研究结果表明,两种方案在临床反应方面存在显著差异。尽管需要进一步研究来证实arTMS的优越性,但应考虑该技术更好的成本效益。