Effect of escitalopram combined with repetitive transcranial magnetic stimulation on efficacy and attention function of patients with first-episode unipolar depression
10.3760/cma.j.cn.115354-20230714-00003
- VernacularTitle:草酸艾司西酞普兰联合重复经颅磁刺激治疗首发单相抑郁症的疗效及对患者注意功能的影响
- Author:
Jianxi HU
1
;
Haobo CHEN
;
Huameng HUANG
;
Rong HU
;
Guihe HU
;
Aihua GUO
;
Man LI
;
Huikun DENG
;
Xiaoping PAN
Author Information
1. 广州市第一人民医院神经内科,广州 510180
- Keywords:
Major depressive disorder;
Escitalopram;
Repetitive transcranial magnetic stimulation;
Attention function;
Dorsolateral prefrontal cortex
- From:
Chinese Journal of Neuromedicine
2023;22(10):1038-1043
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the effect of escitalopram combined with repetitive transcranial magnetic stimulation (rTMS) on efficacy and attention function in patients with first-episode unipolar depression.Methods:Fifty-two first-episode initial-naive unipolar depression patients were enrolled in Department of Neurology of Guangzhou First People's Hospital from March 2022 to April 2023 were chosen. They were randomly allocated to active stimulation group ( n=27) and sham stimulation group ( n=25); both were treated with escitalopram, and active treatment or sham treatment in the left dorsolateral prefrontal cortex (DLPFC) were given for 4 weeks (5 d per week, 20 d totally). Before treatment and 2 and 4 weeks after treatment, Hamilton Depression Rating Scale (HAMD)-24 was used to evaluate depressive symptoms, and Birmingham Cognitive Screening Scale-Chinese (BCoS-C) was used to evaluate the attention function. Results:(1) In terms of depressive symptoms: HAMD-24 scores of the active stimulation group 2 and 4 weeks after treatment (20.63±2.73, 15.85±2.43) were significantly lower than those before treatment (25.74±2.68, P<0.05); HAMD-24 scores of sham stimulation group 4 weeks after treatment were also significantly lower than those before treatment ([20.48±2.33] vs. [25.80±2.57], P<0.05); HAMD-24 scores of the active stimulation group 2 and 4 weeks after treatment were significantly lower than those of sham stimulation group ( P<0.05). (2) In terms of auditory attention indicators: total correct number (selective attention) in active stimulation group 4 weeks after treatment was significantly larger than that before treatment (51.74±1.38 vs. 47.48±1.60), and the sustained index (sustained attention) was significantly lower than that before treatment (0.74±0.71 vs. 4.37±1.15, P<0.05); total correct number in active stimulation group 4 weeks after treatment was significantly larger than that in sham stimulation group (48.00±1.66), and the sustained index was significantly lower than that in sham stimulation group (3.72±1.28, P<0.05). Conclusion:Combined with escitalopram, rTMS can more effectively mitigate the depressive symptoms in first-episode unipolar depression patients, and depressive symptoms improve more quickly than attentional function.