Alzheimer's disease with depressive symptoms: Clinical effect of intermittent theta burst stimulation repetitive transcranial magnetic stimulation.

IF 3.9 4区 医学 Q1 PSYCHIATRY World Journal of Psychiatry Pub Date : 2024-08-19 DOI:10.5498/wjp.v14.i8.1216
Xin Jin, Chun-Yun Xu, Jin-Feng Fei, Yu Fang, Cong-Hao Sun
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Abstract

Background: 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.

Aim: To examine the therapeutic efficacy of iTBS mode of rTMS for treating depressive symptoms in patients with AD.

Methods: 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 (n = 53) and observation (n = 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).

Results: 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 P < 0.05); there were no recorded serious adverse events in either group.

Conclusion: 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.

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伴有抑郁症状的阿尔茨海默病:间歇θ猝发刺激重复经颅磁刺激的临床效果。
背景:阿尔茨海默病(AD)的特点是神经功能持续退化,通常伴有抑郁特征,严重影响患者的生活质量。虽然有多种治疗方法,但疗效有限。近年来,利用θ突发性刺激(TBS)模式的重复经颅磁刺激(rTMS),特别是间歇性TBS(iTBS),在治疗神经精神疾病方面显示出了良好的治疗潜力:这项回顾性研究在2020年1月至2023年12月期间在湖州大学附属湖州市第三医院招募了105名被诊断为AD并伴有抑郁症状的患者。参与者接受标准药物干预,并根据治疗方案分为对照组(53 人)和观察组(52 人)。观察组接受iTBS模式的经颅磁刺激,而对照组接受伪刺激。对比分析评估了住院初期(T0)和治疗后 15 天(T1)的心理健康状况、不良反应和治疗效果:结果:T1时,两组患者的抑郁自评量表和汉密尔顿抑郁量表评分均比T0时明显降低。此外,观察组的降幅比对照组更明显。到了 T1 期,两组的迷你精神状态检查得分都比 T0 期的初始评估有了显著提高。重要的是,与对照组相比,观察组的增长尤为显著。对照组有 14 名患者的治疗效果不佳,而观察组有 5 名患者的治疗效果不佳。此外,与对照组相比,观察组无效治疗的发生率大大降低(P均<0.05);两组均无严重不良事件记录:iTBS经颅磁刺激模式可有效治疗AD合并抑郁症,改善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。
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6.50%
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110
期刊介绍: The World Journal of Psychiatry (WJP) is a high-quality, peer reviewed, open-access journal. The primary task of WJP is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of psychiatry. In order to promote productive academic communication, the peer review process for the WJP is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJP are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in psychiatry.
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