θ短阵快速脉冲重复经颅磁刺激治疗抑郁症

Theta-burst repetitive transcranial magnetic stimulation in treatment of depression: a randomized double blind controlled trial

目的:评估间断θ短阵快速脉冲(iTBS)模式的重复经颅磁刺激(rTMS)治疗抑郁症患者的疗效和安全性。方法:44例符合中国精神障碍分类与诊断标准第3版(CCMD-3)抑郁症诊断的患者随机分为iTBS组和常规组,共接受2周的rTMS治疗。分别在基线、治疗1周及2周后采用24项汉密尔顿抑郁量表(HAMD)、临床总体评定量表(CGI)、抑郁自评量表(SDS)和焦虑自评量表(SAS)评定疗效;以同步听觉连续加法测验(PASAT)评定认知功能。结果:共36例患者完成2周的rTMS治疗,其中iTBS组脱落3例(脱落率14%),常规组脱落5例(脱落率22%)。rTMS治疗2周后,iTBS组和常规组HAMD减分率分别为35.13%(34.46%)、24.62%(29.05%),CGI有效率均为56%。2组间疗效和认知功能的改善差异均无统计学意义。患者均未见严重不良反应。结论:iTBS与常规模式疗效和安全性相当。

Objective To evaluate the safety and efficacy of a novel paradigm of intermittent θ-burst transcranial magnetic stimulation（iTBS） in the treatment of patients with depression.Methods Forty-four consecutive patients with Chinese Classification of Mental Disorders（CCMD）-3 diagnosis of depression were allocated randomly into 2 groups： iTBS group（n=21） and conventional repetitive transcranial magnetic stimulation（rTMS） group（n=23）.All patients were treated for 2 weeks.Efficacy and safety rating scales were assessed at three time points,before TMS（baseline）,at day 7 and 14.Results In iTBS group,3 patients were dropped with a drop rate of 14%,while 5 patients were dropped in conventional group with a drop rate of 22%;36 patients had completed the 2 weeks treatment.After 2 weeks treatment,the improvement rates of Hamilton rating scale for depression（HAMD） in iTBS and conventional groups were 35.13%（34.46%） and 24.62%（29.05%）,respectively.Clinical global impression（CGI） efficacy rate was 56% in both groups.No statistically significant differences in efficacy and improvement of recognition function were seen between the two groups.No severe adverse effects were observed.Conclusions iTBS has comparative efficacy and safety as the conventional rTMS yet the stimulation intensity was lower and the course of time was shorter.