European Neuropsychopharmacology最新文献_第7页

Excess mortality and life-years lost in people diagnosed with depression: A 20-year population-based cohort study of 126,573 depressed individuals followed for 1,139,073 persons-years 被诊断为抑郁症患者的超额死亡率和寿命损失：对 126,573 名抑郁症患者进行了长达 20 年、共 1,139,073 人年的人群队列研究。

IF 6.1 2区医学 Q1 CLINICAL NEUROLOGY

European Neuropsychopharmacology

Pub Date : 2024-11-12 DOI: 10.1016/j.euroneuro.2024.10.009

Heidi Ka Ying Lo , Joe Kwun Nam Chan , Corine Sau Man Wong , Ka Fai Chung , Christoph U Correll , Marco Solmi , Lawrence W Baum , Thuan Quoc Thach , Pak Chung Sham , Wing Chung Chang

Depression is associated with premature mortality, but evidence is mainly derived from Western countries. Very limited research has evaluated shortened lifespan in depression using life-years-lost (LYLs), a recently developed mortality metric taking into account the illness onset for life expectancy estimation. Temporal trends of differential mortality gap are understudied. This population-based cohort study, which utilized a territory-wide medical-record database of public inpatient and outpatient healthcare services in Hong Kong, evaluated the extent of premature mortality in 126,573 individuals with depression (persons-years=1,139,073) between January 2002 and December 2021 regarding the standardized mortality ratio (SMR) and excess LYLs. Trends in annual SMRs over 20 years were assessed by joinpoint analyses. The results showed that individuals with depression exhibited significantly higher all-cause (SMR=1.84 [95% CI=1.82–1.88]), natural-cause (1.69 [1.66–1.72]), and unnatural-cause (5.24 [4.97–5.51]) mortality rates than the general population. Suicide-specific SMR was markedly elevated (7.92 [7.47–8.38]), particularly in the 15–34 year-olds (12.75 [10.87–14.79]). Respiratory diseases, cardiovascular diseases and cancers accounted for the majority of deaths. Excess LYLs extended to men (5.67 years, 95% CI = 5.45–5.90) and women (4.06 years, 95% CI = 3.89–4.23). Overall and natural-cause mortality rates improved over time, but unnatural-cause and suicide-related mortality gaps persisted. Taken together, this study indicates that depression is associated with increased premature mortality and reduced lifespan in a predominantly Chinese population, mainly attributed to natural causes. Relative suicide-specific mortality is substantially elevated, especially among young people. The pronounced mortality gap underscores an urgent need for effective interventions targeting improved physical health and suicide risk reduction in individuals with depression.

抑郁症与过早死亡有关，但证据主要来自西方国家。使用寿命损失年数（LYLs）对抑郁症导致的寿命缩短进行评估的研究非常有限，而寿命损失年数是最近开发的一种死亡率指标，在估算预期寿命时考虑了疾病的发病时间。对不同死亡率差距的时间趋势研究不足。这项以人群为基础的队列研究利用香港公共住院和门诊医疗服务的全港医疗记录数据库，评估了2002年1月至2021年12月期间126,573名抑郁症患者（人年=1,139,073）的过早死亡程度，涉及标准化死亡率（SMR）和超额LYLs。通过连接点分析评估了 20 年间每年 SMR 的趋势。结果显示，抑郁症患者的全因死亡率（SMR=1.84 [95% CI=1.82-1.88]）、自然原因死亡率（1.69 [1.66-1.72]）和非自然原因死亡率（5.24 [4.97-5.51]）明显高于普通人群。自杀的具体 SMR 明显升高（7.92 [7.47-8.38]），特别是在 15-34 岁的人群中（12.75 [10.87-14.79]）。死亡原因主要是呼吸系统疾病、心血管疾病和癌症。男性（5.67 岁，95% CI = 5.45-5.90）和女性（4.06 岁，95% CI = 3.89-4.23）的长寿年限过长。随着时间的推移，总死亡率和自然原因死亡率有所改善，但非自然原因死亡率和自杀相关死亡率的差距依然存在。综上所述，本研究表明，在以中国人为主的人群中，抑郁症与过早死亡率增加和寿命缩短有关，主要归因于自然原因。自杀导致的死亡率相对较高，尤其是在年轻人中。明显的死亡率差距突出表明，迫切需要采取有效干预措施，改善抑郁症患者的身体健康并降低自杀风险。

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引用次数: 0

Environmentally conscious psychopharmacotherapy: Practice recommendations for psychiatrists 环境意识心理药物疗法：给精神科医生的实践建议。

IF 6.1 2区医学 Q1 CLINICAL NEUROLOGY

European Neuropsychopharmacology

Pub Date : 2024-11-12 DOI: 10.1016/j.euroneuro.2024.10.003

Jurjen J. Luykx , Caroline T.A. Moermond , Lisa Page , Unax Lertxundi , Christiaan H. Vinkers

Despite the multifaceted negative influences of psychotropic medications on the environment, an overview of such effects and of actions to curtail them is currently lacking. We therefore summarized the most relevant literature on what we refer to as Environmentally Conscious Psychopharmacotherapy (ECP), i.e., prescribing the most appropriate psychotropic medications for patients while at the same time considering the wellbeing of the planet. In our literature appraisal we identified viable actions at the levels of industry, physicians, pharmacists, patients, and policymakers that can reduce the environmental hazards associated with psychotropics. We divided these actions into the following categories: careful treatment selection, curtailing overprescribing, adequate disposal of medication by users, and transparent reporting of environmental risk. For each of these categories, we give examples of practices are in line with ECP, which in turn has the potential to reduce the impact of psychotropic medication prescribing practices on the environment. We note that many such practices result in co-benefits for patients, prescribers and the environment. On the other hand, evidence on environmental impact is lacking for several factors related to these medications, e.g., geographical region of manufacturing, duration of use, pharmacological vs. non-pharmaceutical treatment options, and ecotoxicological data. We conclude that general as well as disorder-specific considerations for clinicians prescribing psychotropics already carry the potential to limit the environmental burden associated with these agents. Future research aimed at filling the knowledge gaps we identified is likely to substantially advance ECP in the near future.

尽管精神药物会对环境造成多方面的负面影响，但目前还缺乏对这些影响以及如何减少这些影响的概述。因此，我们总结了最相关的文献，我们称之为环保意识精神药物疗法（ECP），即在为患者开具最合适的精神药物处方的同时考虑到地球的福祉。在文献评估中，我们从行业、医生、药剂师、患者和政策制定者等层面确定了可行的行动，以减少精神药物对环境的危害。我们将这些行动分为以下几类：谨慎选择治疗方法、减少过量处方、使用者对药物进行适当处置以及透明地报告环境风险。对于其中的每一类，我们都举例说明了符合 ECP 的做法，这些做法反过来又有可能减少精神药物处方对环境的影响。我们注意到，许多此类做法对患者、处方者和环境都有好处。另一方面，对于与这些药物相关的几个因素，如生产地理区域、使用时间长短、药物治疗与非药物治疗的选择以及生态毒理学数据，还缺乏环境影响方面的证据。我们的结论是，临床医生在开具精神药物处方时的一般考虑因素以及针对特定疾病的考虑因素都有可能限制与这些药物相关的环境负担。未来旨在填补我们发现的知识空白的研究很可能会在不久的将来大大推动 ECP 的发展。

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引用次数: 0

Fetal Fentanyl Syndrome – Only the “tip of the iceberg”? 胎儿芬太尼综合征--只是 "冰山一角"？

IF 6.1 2区医学 Q1 CLINICAL NEUROLOGY

European Neuropsychopharmacology

Pub Date : 2024-11-08 DOI: 10.1016/j.euroneuro.2024.10.011

Károly Mirnics

引用次数: 0

The microRNA profile of brain-derived extracellular vesicles: A promising step forward in developing pharmacodynamic biomarkers for psychiatric disorders 脑源性细胞外囊泡的 microRNA 图谱：在开发精神疾病药效学生物标记物方面迈出充满希望的一步

IF 6.1 2区医学 Q1 CLINICAL NEUROLOGY

European Neuropsychopharmacology

Pub Date : 2024-11-06 DOI: 10.1016/j.euroneuro.2024.10.002

Mojtaba Oraki Kohshour , Urs Heilbronner , Thorsten Mueller , Moritz Rossner , Sergi Papiol , Thomas G. Schulze

MicroRNAs (miRNAs) have the potential to affect drug metabolism, and some drugs affect cellular miRNA expression. miRNAs are found inside extracellular vesicles (EVs), and the profile of these EV-miRNAs can change across different diseases and disease states. Consequently, in recent years EV-miRNAs have attracted increasing attention as possible non-invasive biomarkers. For example, analyzing the miRNA expression profile of brain-derived EVs in blood may allow us to non-invasively assess miRNA dysregulation and thus to gain knowledge about the pathophysiology of psychiatric disorders and identify potential new predictive targets. We searched PubMed for all studies related to the effects of psychiatric medications on EV-miRNAs and identified 14 relevant articles. Taken together, findings indicate that certain EV-miRNAs may be targets for psychiatric medications and that antipsychotics such as olanzapine and antidepressants such as fluoxetine may alter the expression levels of particular EV-miRNAs. If confirmed and replicated, these findings may lead to the suggested miRNA profiles being used as pharmacodynamic biomarkers. However, heterogeneities and uncertainties remain regarding the role of EV-miRNAs in psychiatric disorders and their interaction with neuronal gene expression and drugs. This minireview summarizes some of the findings on the effects of psychiatric medications on EV-miRNAs and describes the potential role of EV-miRNAs as pharmacodynamic biomarkers for psychiatric disorders.

微小RNA（miRNA）可能会影响药物代谢，有些药物会影响细胞中miRNA的表达。miRNA存在于细胞外囊泡（EV）中，这些EV-miRNA的特征在不同疾病和疾病状态下会发生变化。因此，近年来，EV-miRNA 作为可能的非侵入性生物标记物引起了越来越多的关注。例如，分析血液中脑源EVs的miRNA表达谱可让我们非侵入性地评估miRNA失调，从而了解精神疾病的病理生理学并确定潜在的新预测靶点。我们在PubMed上搜索了所有与精神科药物对EV-miRNA影响相关的研究，并确定了14篇相关文章。综上所述，研究结果表明，某些EV-miRNA可能是精神科药物的靶点，奥氮平等抗精神病药物和氟西汀等抗抑郁药物可能会改变特定EV-miRNA的表达水平。如果这些发现得到证实和复制，可能会将建议的 miRNA 图谱用作药效学生物标志物。然而，关于 EV-miRNA 在精神疾病中的作用及其与神经元基因表达和药物之间的相互作用，仍然存在异质性和不确定性。本微综述总结了精神科药物对 EV-miRNAs 影响的一些研究结果，并阐述了 EV-miRNAs 作为精神疾病药效学生物标记物的潜在作用。

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引用次数: 0

Placental epigenetic signatures of maternal distress in glucocorticoid-related genes and newborn outcomes: A study of Spanish primiparous women 糖皮质激素相关基因中孕产妇痛苦的胎盘表观遗传学特征与新生儿结局：对西班牙初产妇的研究。

IF 6.1 2区医学 Q1 CLINICAL NEUROLOGY

European Neuropsychopharmacology

Pub Date : 2024-11-06 DOI: 10.1016/j.euroneuro.2024.10.001

Agueda Castro-Quintas , Helena Palma-Gudiel , Elisenda Eixarch , Nerea San Martín González , Simone Röh , Susann Sauer , Monika Rex-Haffner , Jose Luis Monteserin-Garcia , Lorena de la Fuente-Tomás , Fatima Crispi , Maria Paz Garcia Portilla , Elisabeth B. Binder , Lourdes Fañanas

Maternal stress during pregnancy can impact offspring health, increasing the risk of neuropsychiatric disorders. The human placenta plays a crucial role in understanding this effect, influencing fetal programming as it connects maternal and fetal circulation. Our hypothesis centers on maternal stress influencing children's outcomes through placental DNA methylation, targeting three cortisol-regulating genes: NR3C1, FKBP5, and HSD11B2.

In this pilot study, chorionic villi and maternal decidua placental layers from 45 mother-infant dyads (divided into two groups based on high/low maternal stress exposure) were analyzed for DNA methylation at the genes of interest via targeted bisulfite sequencing. Pregnant women provided four saliva samples throughout a day for cortisol determinations and were assessed for the presence of depressive symptoms at each of the three trimesters of pregnancy. Newborns underwent neurodevelopmental assessments and salivary cortisol evaluations at 7 weeks.

Increased maternal diurnal cortisol levels in the first trimester of pregnancy was significantly associated with elevated DNA methylation at exon 1D of the NR3C1 gene and lower DNA methylation at intron 7 of the FKBP5 gene, both in chorionic villi samples. Elevated DNA methylation at introns 1 and 7 of FKBP5 in the maternal decidua were strongly linked to an anticipated delivery. DNA methylation at the HSD11B2 promoter region was uniformly low across all placental samples. No associations with newborn neurodevelopment were found.

These results emphasize the importance of exploring layer-specific methylation differences at distinct pregnancy stages, highlighting the complex interplay between maternal stress, placental epigenetic modifications, and fetal development throughout the prenatal period.

孕期母体的压力会影响后代的健康，增加患神经精神疾病的风险。人类胎盘在了解这种影响方面起着至关重要的作用，它连接着母体和胎儿的血液循环，影响着胎儿的发育。我们的假说集中于母体压力通过胎盘 DNA 甲基化影响儿童的结果，目标是三个皮质醇调节基因：NR3C1、FKBP5 和 HSD11B2。在这项试验性研究中，通过靶向亚硫酸氢盐测序分析了45对母婴（根据母婴压力暴露程度分为高/低两组）的绒毛和母体蜕膜胎盘层中相关基因的DNA甲基化情况。孕妇每天提供四份唾液样本用于皮质醇测定，并在怀孕三个月的每个阶段对是否存在抑郁症状进行评估。新生儿在 7 周时接受神经发育评估和唾液皮质醇评估。在绒毛样本中，妊娠头三个月母体昼夜皮质醇水平的升高与NR3C1基因外显子1D的DNA甲基化升高和FKBP5基因内含子7的DNA甲基化降低有显著关联。母体蜕膜中 FKBP5 基因内含子 1 和 7 的 DNA 甲基化升高与预产期密切相关。在所有胎盘样本中，HSD11B2 启动子区域的 DNA 甲基化程度都很低。没有发现与新生儿神经发育有关的关联。这些结果强调了在不同妊娠阶段探索特定层甲基化差异的重要性，突出了整个产前期间母体压力、胎盘表观遗传修饰和胎儿发育之间复杂的相互作用。

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引用次数: 0

A meta-analysis of data-driven cognitive subgroups in bipolar disorder 双相情感障碍认知分组数据荟萃分析

IF 6.1 2区医学 Q1 CLINICAL NEUROLOGY

European Neuropsychopharmacology

Pub Date : 2024-11-06 DOI: 10.1016/j.euroneuro.2024.10.008

E Bora

The delineation of cognitive subgroups of bipolar disorder (BD) might be helpful for identifying biologically valid subtypes of this disorder. This meta-analysis identified peer-reviewed literature on studies investigating cognitive subgroups of BD with data-driven clustering methods. Relevant studies were searched in PubMed, Scopus, and Web of Science. Random-effects meta-analysis was performed using R software. A total of 14 cross-sectional studies including euthymic or mildly symptomatic patients with BD were included in the current meta-analysis. The available studies have consistently supported a 3-cluster solution. The pooled prevalence of the severe-impairment, moderate-impairment, and major good-functioning groups were 23.1 % (95%CI, 18.5 %–27.7 %), 42.5 % (95%CI, 36.3 %–48.8 %), and 33.5 % (95%CI, 25.9 %–41.1 %) respectively. Compared to healthy controls, both the severe-impairment (g=−1.40 to −1.73) and moderate-impairment groups (g=−0.59 to −0.96) had significant deficits in all six cognitive domains (verbal memory, visual memory, executive functions, working memory, attention and processing speed). The good-performance subgroup had a small increase in the performance of executive functions (g=0.23) and normal functioning in all other domains. Compared to the good-performance subgroup, the severe-impairment subgroup was characterized by more severe functional impairment, more hospital admissions, a higher percentage of type I BD and antipsychotic use. The characteristics of the moderate-impairment subgroup were lying between the other two subgroups for most of the measures. The current findings support the existence of 3 cognitive subgroups in BD including severe-impairment and moderate-impairment groups which are associated with a more severe course of illness.

双相情感障碍（BD）认知亚组的划分可能有助于确定该障碍在生物学上有效的亚型。这项荟萃分析采用数据驱动的聚类方法，对调查双相情感障碍认知亚组的研究进行了同行评议，并确定了相关文献。相关研究在 PubMed、Scopus 和 Web of Science 中进行了检索。使用 R 软件进行随机效应荟萃分析。目前的荟萃分析共纳入了 14 项横断面研究，其中包括无症状或症状轻微的 BD 患者。现有研究一致支持 3 簇解决方案。重度受损组、中度受损组和主要功能良好组的汇总患病率分别为 23.1%（95%CI，18.5%-27.7%）、42.5%（95%CI，36.3%-48.8%）和 33.5%（95%CI，25.9%-41.1%）。与健康对照组相比，重度受损组（g=-1.40 至-1.73）和中度受损组（g=-0.59 至-0.96）在所有六个认知领域（言语记忆、视觉记忆、执行功能、工作记忆、注意力和处理速度）均存在显著缺陷。表现良好的亚组在执行功能方面的表现略有提高（g=0.23），而在所有其他领域的表现正常。与表现良好亚组相比，重度受损亚组的特点是功能受损更严重、入院次数更多，I 型 BD 的比例更高，并使用抗精神病药物。中度受损亚组在大多数测量指标上的特征介于其他两个亚组之间。目前的研究结果支持在 BD 中存在 3 个认知亚组，包括重度损伤组和中度损伤组，它们与更严重的病程有关。

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引用次数: 0

“The role of gut microbiota in adult attention deficit hyperactivity disorder: Insights and implications” "肠道微生物群在成人注意缺陷多动障碍中的作用：见解和影响"

IF 6.1 2区医学 Q1 CLINICAL NEUROLOGY

European Neuropsychopharmacology

Pub Date : 2024-11-06 DOI: 10.1016/j.euroneuro.2024.09.008

Muhammad Hussnain Sadiq, Ayesha Fatima

引用次数: 0

IF 6.1 2区医学 Q1 CLINICAL NEUROLOGY

European Neuropsychopharmacology

Pub Date : 2024-11-06 DOI: 10.1016/j.euroneuro.2024.10.010

Jiannan Zhu , Lu Hou , Qin Zhou , Rongrong Lu , Zhiqiang Du , Ying Jiang , Haohao Zhu

引用次数: 0

Efficacy and safety profile of oral creatine monohydrate in add-on to cognitive-behavioural therapy in depression: An 8-week pilot, double-blind, randomised, placebo-controlled feasibility and exploratory trial in an under-resourced area 口服一水肌酸对抑郁症认知行为疗法的疗效和安全性：在资源匮乏地区进行的为期 8 周的双盲、随机、安慰剂对照可行性和探索性试验。

IF 6.1 2区医学 Q1 CLINICAL NEUROLOGY

European Neuropsychopharmacology

Pub Date : 2024-11-01 DOI: 10.1016/j.euroneuro.2024.10.004

Nima Norbu Sherpa , Riccardo De Giorgi , Edoardo Giuseppe Ostinelli , Amrita Choudhury , Tenzin Dolma , Sangila Dorjee

Pre-clinical and clinical evidence proposes that creatine monohydrate, an affordable nutraceutical, could be a useful adjunct to conventional antidepressant treatments. In this pilot feasibility and exploratory study, we investigate the 8-week effects of creatine in addition to cognitive-behavioural therapy (CBT) versus placebo plus CBT in depression. For the primary efficacy outcome of change in Patient Health Questionnaire-9 depression score at study endpoint, we used mixed-model repeated measures analysis of covariance. Logistic regressions were employed to assess acceptability (any-cause dropouts), tolerability (dropouts for adverse events), and safety (patients experiencing one or more adverse events). We calculated effect sizes adjusted for age, sex, and baseline depression score. One-hundred participants (50 females, mean age= 30.4 ± 7.4 years) with depression (mean PHQ-9 = 17.6 ± 6.3) were randomised to either creatine+CBT (N = 50) or placebo+CBT (N = 50). At 8 weeks, PHQ-9 scores were lower in both study arms, but significantly more so in participants taking creatine (mean difference= -5.12). Treatment discontinuations due to any cause and to adverse events, and proportion of participants with at least one adverse event were comparable between study arms. This hypothesis-generating trial suggests that creatine could be a useful and safe supplement to CBT for depression. Longer and larger clinical trials are warranted.

临床前和临床证据表明，一水肌酸这种经济实惠的营养保健品可以作为传统抗抑郁治疗的有效辅助药物。在这项试验性可行性和探索性研究中，我们调查了肌酸在认知行为疗法（CBT）基础上与安慰剂加 CBT 相比对抑郁症患者的 8 周疗效。对于研究终点时患者健康问卷-9 抑郁症评分变化这一主要疗效结果，我们采用了混合模型重复测量协方差分析法。逻辑回归用于评估可接受性（任何原因的退出）、耐受性（因不良事件退出）和安全性（出现一次或多次不良事件的患者）。我们计算了根据年龄、性别和基线抑郁评分调整后的效应大小。100 名抑郁症患者（50 名女性，平均年龄= 30.4 ± 7.4 岁）（平均 PHQ-9 = 17.6 ± 6.3）被随机分配到肌酸+CBT（50 人）或安慰剂+CBT（50 人）治疗方案中。8周时，两个研究组的PHQ-9评分均有所下降，但服用肌酸的参与者的PHQ-9评分明显更高（平均差异=-5.12）。因任何原因和不良事件导致的治疗中断，以及出现至少一种不良事件的参与者比例，在各研究组之间不相上下。这项提出假设的试验表明，肌酸可以作为抑郁症 CBT 的一种有用且安全的补充。有必要进行更长时间和更大规模的临床试验。

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引用次数: 0

Does 18 Hz deep TMS benefit a different subgroup of depressed patients relative to 10 Hz rTMS? The role of the individual alpha frequency 与 10 赫兹经颅磁刺激相比，18 赫兹深部经颅磁刺激是否能使不同亚组的抑郁症患者受益？个体阿尔法频率的作用

IF 6.1 2区医学 Q1 CLINICAL NEUROLOGY

European Neuropsychopharmacology

Pub Date : 2024-10-12 DOI: 10.1016/j.euroneuro.2024.09.007

Helena Voetterl , Uri Alyagon , Victoria J. Middleton , Jonathan Downar , Abraham Zangen , Alexander T. Sack , Hanneke van Dijk , Aimee Halloran , Nancy Donachie , Martijn Arns

Both 10 Hz repetitive transcranial magnetic stimulation (rTMS) as well as 18 Hz deep TMS (dTMS) constitute effective, FDA-approved TMS treatment protocols for depression. However, not all patients experience sufficient symptom relief after either of these protocols. Biomarker-guided treatment stratification could aid in personalizing treatment and thereby enhancing improvement. An individual alpha frequency (iAF)-based EEG-biomarker, Brainmarker-I, can differentially stratify patients to depression treatments. For instance, an iAF close to 10 Hz was associated with better improvement to 10 Hz rTMS, possibly reflecting entrainment of endogenous oscillations to the stimulation frequency.

Accordingly, we examined whether 18 Hz dTMS would result in better improvement in individuals whose iAF lies around 9 Hz, a harmonic frequency of 18 Hz.

Curve fitting and regression analyses were conducted to assess the relation between iAF and improvement. For treatment stratification purposes, correlations with iAF-distance to 10 Hz compared 18 Hz dTMS (N = 114) to 10 Hz rTMS (N = 72).

We found a robust quadratic effect, indicating that patients with an iAF around 9 Hz exhibited least symptom improvement (r²=0.126, p<.001). Improvement correlated positively with iAF-distance to 10 Hz (p=.003). A secondary analysis in 20 Hz figure-of-eight data confirmed this direction. A significant interaction of iAF-distance and stimulation frequency between 10 and 18 Hz datasets emerged (p=.026).

These results question entrainment of endogenous oscillations by their harmonic frequency for 18 Hz, and suggest that 10 Hz and 18 Hz TMS target different subgroups of depression patients. This study adds to iAF stratification, augmenting Brainmarker-I with alternative TMS protocols (18 Hz/20 Hz) for patients with a slower iAF, thereby broadening clinical applicability and relevance of the biomarker.

10 赫兹重复经颅磁刺激（rTMS）和 18 赫兹深部经颅磁刺激（dTMS）都是经美国食品及药物管理局批准的有效抑郁症经颅磁刺激治疗方案。然而，并非所有患者在接受这两种治疗方案后症状都能得到充分缓解。以生物标志物为指导的治疗分层有助于个性化治疗，从而改善病情。基于个体α频率（iAF）的脑电图生物标志物--Brainmarker-I，可以对抑郁症患者进行分层治疗。例如，iAF接近10赫兹与10赫兹经颅磁刺激的改善效果更佳相关，这可能反映了内源性振荡对刺激频率的诱导作用。因此，我们研究了iAF位于9赫兹（18赫兹的谐波频率）附近的个体，18赫兹经颅磁刺激是否会带来更好的改善效果。出于治疗分层的目的，将 18 赫兹经颅磁刺激（N = 114）与 10 赫兹经颅磁刺激（N = 72）进行了比较。我们发现了一个强有力的二次效应，表明 iAF 在 9 赫兹左右的患者症状改善最少（r2=0.126，p<.001）。改善程度与 iAF 与 10 赫兹的距离呈正相关（p=.003）。对 20 赫兹八位数数据的二次分析证实了这一方向。在10赫兹和18赫兹数据集之间，iAF-距离与刺激频率之间出现了明显的交互作用（p=.026）。这些结果质疑了18赫兹谐波频率对内源性振荡的诱导作用，并表明10赫兹和18赫兹TMS针对的是不同的抑郁症患者亚群。这项研究为iAF分层增添了新的内容，为iAF较慢的患者提供了可供选择的TMS方案（18赫兹/20赫兹）来增强Brainmarker-I，从而扩大了生物标记的临床适用性和相关性。

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引用次数: 0