Bakir Cicek N, Nakonezny Paul A, Buyuktaskin Dicle, Sangster-Carrasco Lucero, Azamet Irem, Vande Voort Jennifer, Croarkin Paul E
Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, USA.
Transcranial Magn Stimul. 2025 Apr;3. doi: 10.1016/j.transm.2025.100093. Epub 2025 Apr 8.
This feasibility study focused on a staged approach to transcranial magnetic stimulation (TMS) interventions for adolescents with depression. Adolescents (N = 6) who did not respond to standard TMS were offered a two-week course of either continuous or intermittent theta burst stimulation (TBS) based on an intracortical facilitation - (ICF) biomarker. A within-subjects linear mixed model analysis of repeated measures was conducted to assess changes in depressive symptoms using the Children's Depression Rating Scale-Revised (CDRS-R). The analysis revealed a significant overall improvement in depressive symptoms from baseline to 6-month follow-up (p = 0.02; d=0.82). Significant pairwise comparisons were observed between baseline and week 2 [LSM decrease = -5.83 (SE = 2.`21), adjusted p = 0.04], and between baseline and 6-month follow-up [LSM decrease = -18.39 (SE = 7.05), adjusted p = 0.04]. There is a theoretical rationale for the use of ICF to guide dosing of TBS and this study suggests feasibility. While this study does not provide evidence to support the utility of the ICF biomarker, it may provide a template for future studies.
这项可行性研究聚焦于对患有抑郁症的青少年采用分阶段的经颅磁刺激（TMS）干预方法。对未对标准TMS产生反应的青少年（N = 6），根据皮质内易化（ICF）生物标志物，为其提供为期两周的连续或间歇性theta爆发刺激（TBS）疗程。使用儿童抑郁评定量表修订版（CDRS-R）进行重复测量的受试者内线性混合模型分析，以评估抑郁症状的变化。分析显示，从基线到6个月随访，抑郁症状有显著的总体改善（p = 0.02；d = 0.82）。在基线与第2周之间[最小二乘均数减少=-5.83（标准误=2.21），校正p = 0.04]，以及基线与6个月随访之间[最小二乘均数减少=-18.39（标准误=7.05），校正p = 0.04]观察到显著的成对比较。使用ICF指导TBS剂量有理论依据，本研究表明了其可行性。虽然本研究没有提供证据支持ICF生物标志物的效用，但它可能为未来的研究提供一个模板。
