An exploratory randomised controlled study on the efficacy and safety of deep transcranial magnetic stimulation in the treatment of depression
10.3760/cma.j.cn113661-20220920-00266
- VernacularTitle:深部经颅磁刺激治疗抑郁症疗效及安全性的探索性随机对照研究
- Author:
Li YANG
1
;
Ruojia REN
1
;
Wenting LU
1
;
Tianyu ZHAO
1
;
Shijie GUO
1
;
Bufan LIU
1
;
Fanfan HUANG
1
;
Huan CHEN
1
;
Na JIN
1
;
Quan LIN
1
;
Yuehang XU
1
;
Xueyi WANG
1
Author Information
1. 河北医科大学第一医院精神卫生中心 河北省精神心理疾病临床医学研究中心 河北省精神卫生研究所，石家庄 050031
- Publication Type:Journal Article
- Keywords:
Depressive disorder;
Transcranial magnetic stimulation;
Validation studies;
Safety
- From:
Chinese Journal of Psychiatry
2023;56(3):161-166
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of deep transcranial magnetic stimulation (dTMS) as an adjunctive treatment for depression.Methods:From May 2021 to June 2022, 56 patients aged 18-60 who met the diagnostic criteria in the International Classification of Diseases (ICD-10) for depression were recruited from the Mental Health Center of the First Hospital of Hebei Medical University.According to the random number table method, they were divided into dTMS combined with the drug treatment group (dTMS group, n=28), and the repetitive transcranial magnetic stimulation(rTMS) combined with the drug treatment group (rTMS group, n=28). Both groups received dTMS or rTMS based on drug therapy, 5 times weekly for 2 weeks in total. At the baseline and the end of 2nd week of treatment, the Hamilton Depression Rating Scale (HAMD 17) and Hamilton Anxiety Rating Scale (HAMA) were used to assess patients′ depression and anxiety symptoms, and the 32-Item Hypomania Checklist (HCL-32) was used to assess the risk of mania after treatment.The reductions on HAMD 17 and HAMA were the primary assessment, and the treatment response rate in HAMD 17, adverse events and the risk of switching to mania were also assessed. The efficacy was compared between the two groups by using independent samples t-test and chi-square test. Results:There was no significant difference in baseline HAMD 17 and HAMA scores between the two groups ( P>0.05). At the end of 2nd week of the treatment, The HAMD 17 reduction and the reduction rate were higher in the dTMS group than in the rTMS group( t=3.27, P=0.02; t=2.11, P=0.04). The HAMA reduction and the reduction rate showed a trend favouring the dTMS group, but the difference was insignificant ( t=1.03, P=0.31; t=0.76, P=0.45). The treatment response rates on the HAMD 17 assessment were 52.2%(12/23) and 38.5% (10/26) in the dTMS and rTMS groups, respectively. However, the difference was not statistically significant (χ 2=0.93, P=0.34). The overall incidence of adverse events was 14.3% (4/28) in the dTMS group and 7.1% (2/28) in the rTMS group, with no significant differences between the two groups (χ 2=0.19, P=0.67). All subjective discomforts during the treatment automatically resolved within three days, and no mania was reported. Conclusion:As the adjunctive treatment, both TMS protocols are safe and effective in relieving the depressive and anxious symptoms of depressive disorder, and the adjunctive dTMS seems better in treating depressive symptoms than rTMS.
