Accelerated Theta Burst Transcranial Magnetic Stimulation for Refractory Depression in Autism Spectrum Disorder.

IF 3.2 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL Journal of Autism and Developmental Disorders Pub Date : 2025-03-01 Epub Date: 2024-05-15 DOI:10.1007/s10803-024-06244-2
Elizabeth Blank, Donald L Gilbert, Steve W Wu, Travis Larsh, Rana Elmaghraby, Rui Liu, Elizabeth Smith, Grace Westerkamp, Yanchen Liu, Paul S Horn, Ethan Greenstein, John A Sweeney, Craig A Erickson, Ernest V Pedapati
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Abstract

Purpose: Major depressive disorder (MDD) disproportionately affects those living with autism spectrum disorder (ASD) and is associated with significant impairment and treatment recidivism.

Methods: We studied the use of accelerated theta burst stimulation (ATBS) for the treatment of refractory MDD in ASD (3 treatments daily x 10 days). This prospective open-label 12-week trial included 10 subjects with a mean age of 21.5 years, randomized to receive unilateral or bilateral stimulation of the dorsolateral prefrontal cortex.

Results: One participant dropped out of the study due to intolerability. In both treatment arms, depressive symptoms, scored on the Hamilton Depression Rating Scale scores, diminished substantially. At 12 weeks post-treatment, full remission was sustained in 5 subjects and partial remission in 3 subjects. Treatment with ATBS, regardless of the site of stimulation, was associated with a significant, substantial, and sustained improvement in depressive symptomatology via the primary outcome measure, the Hamilton Depression Rating Scale. Additional secondary measures, including self-report depression scales, fluid cognition, and sleep quality, also showed significant improvement. No serious adverse events occurred during the study. Mild transient headaches were infrequently reported, which are expected side effects of ATBS.

Conclusion: Overall, ATBS treatment was highly effective and well-tolerated in individuals with ASD and co-occurring MDD. The findings support the need for a larger, sham-controlled randomized controlled trial to further evaluate efficacy of ATBS in this population.

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加速 Theta Burst 经颅磁刺激治疗自闭症谱系障碍患者的难治性抑郁症。
目的:重度抑郁障碍(MDD)对自闭症谱系障碍(ASD)患者的影响尤为严重,并且与严重的功能障碍和治疗累犯有关:我们研究了加速θ脉冲刺激(ATBS)用于治疗 ASD 患者的难治性 MDD(每天 3 次治疗 x 10 天)。这项为期12周的前瞻性开放标签试验包括10名受试者,他们的平均年龄为21.5岁,随机接受单侧或双侧背外侧前额叶皮层刺激:一名受试者因不能耐受而退出研究。两个治疗组的抑郁症状(按汉密尔顿抑郁量表评分)均大幅减轻。治疗后12周,5名受试者的症状持续完全缓解,3名受试者的症状持续部分缓解。通过汉密尔顿抑郁评定量表这一主要结果测量指标,ATBS 治疗(无论刺激部位如何)与抑郁症状的显著、实质性和持续改善相关。其他次要测量指标,包括抑郁自评量表、流体认知和睡眠质量,也有明显改善。研究期间未发生严重不良事件。轻微的一过性头痛很少见,这是ATBS的预期副作用:总的来说,ATBS疗法对患有自闭症和并发精神障碍的患者非常有效,而且耐受性良好。研究结果表明,有必要进行更大规模的假对照随机对照试验,以进一步评估ATBS在这一人群中的疗效。
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来源期刊
CiteScore
8.00
自引率
10.30%
发文量
433
期刊介绍: The Journal of Autism and Developmental Disorders seeks to advance theoretical and applied research as well as examine and evaluate clinical diagnoses and treatments for autism and related disabilities. JADD encourages research submissions on the causes of ASDs and related disorders, including genetic, immunological, and environmental factors; diagnosis and assessment tools (e.g., for early detection as well as behavioral and communications characteristics); and prevention and treatment options. Sample topics include: Social responsiveness in young children with autism Advances in diagnosing and reporting autism Omega-3 fatty acids to treat autism symptoms Parental and child adherence to behavioral and medical treatments for autism Increasing independent task completion by students with autism spectrum disorder Does laughter differ in children with autism? Predicting ASD diagnosis and social impairment in younger siblings of children with autism The effects of psychotropic and nonpsychotropic medication with adolescents and adults with ASD Increasing independence for individuals with ASDs Group interventions to promote social skills in school-aged children with ASDs Standard diagnostic measures for ASDs Substance abuse in adults with autism Differentiating between ADHD and autism symptoms Social competence and social skills training and interventions for children with ASDs Therapeutic horseback riding and social functioning in children with autism Authors and readers of the Journal of Autism and Developmental Disorders include sch olars, researchers, professionals, policy makers, and graduate students from a broad range of cross-disciplines, including developmental, clinical child, and school psychology; pediatrics; psychiatry; education; social work and counseling; speech, communication, and physical therapy; medicine and neuroscience; and public health.
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