Comparing the efficacy of transcranial magnetic stimulation for the treatment of depressive disorder with different targets selection and localization
10.3760/cma.j.cn113661-20210408-00132
- VernacularTitle:不同靶点和定位方法的经颅磁刺激治疗抑郁症的疗效比较
- Author:
Gai KONG
1
;
Mengting SHEN
1
;
Xuanhong ZHANG
1
;
Zhenying QIAN
1
;
Junjuan ZHU
1
;
Tianhong ZHANG
1
;
Bin XIE
1
;
Huafang LI
1
;
Jijun WANG
1
;
Yingying TANG
1
Author Information
1. 上海交通大学医学院附属精神卫生中心，上海 200030
- Publication Type:Journal Article
- Keywords:
Depressive disorder;
Transcranial magnetic stimulation;
Precise TMS navigation;
Dorsolateral prefrontal cortex;
Orbital frontal cortex
- From:
Chinese Journal of Psychiatry
2022;55(1):24-29
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Compared to imprecisely repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC), this study aimed to explore whether localizing the DLPFC precisely or targeting on the right orbital frontal cortex (rOFC) can improve the rTMS efficacy for the treatment of depressive disorder.Methods:From January 2018 to March 2021, this study recruited patients who met the DSM-Ⅳ diagnostic criteria for depressive disorder in Shanghai Mental Health Center. Nineteen patients were located in the imprecise DLPFC group, 19 patients in the precise DLPFC group, and 14 patients in the rOFC group. All patients were assessed by the 17-item Hamilton Depression Scale (HAMD 17) and Hamilton Anxiety Scale (HAMA) at baseline and after 10-session rTMS treatments. The primary outcome of this study was the HAMD 17 response rate, and the second outcome included the reduction score and reduction ratio of the HAMD 17/HAMA. Results:At baseline, there was no significant group difference in HAMD 17 or HAMA scores among the three groups. After the rTMS treatment, the HAMD 17 response rate was significantly different among the three groups (χ2=6.86, P=0.032). The HAMD 17 response rate in the precise DLPFC group (74%) was significantly higher than that in the imprecise DLPFC group (32%, χ2=6.76, P=0.011), but was comparable with that in the rOFC group (57%, χ2=2.16, P=0.133). HAMD 17 response rate did not significantly differ between the precise DLPFC group and the rOFC group (χ2=0.99, P=0.266). The HAMD 17 reduction score tended to be significantly different among the three groups ( F=2.95, P=0.062), with the precise DLPFC group presented the highest HAMD 17 reduction score. There were no significantly differences in the reduction score of HAMD and the reduction ratio of HAMA and HAMD 17 among the three groups. Conclusions:Precisely localizing the DLPFC target may be helpful to improve the rTMS efficacy for the treatment of depressive disorder, while rOFC may be a candidate target for rTMS treatment of the depressive disorder.
