The effects of deep Theta burst stimulation applied to the bilateral dorsolateral prefrontal cortex on depressive symptoms and executive functions in patients with depression
10.3760/cma.j.cn113661-20250208-00055
- VernacularTitle:深部Theta爆发式刺激作用于双侧背外侧前额叶皮质对抑郁症患者抑郁症状与执行功能的影响
- Author:
Haoran ZHANG
1
;
Lulu YU
1
;
Ruojia REN
1
;
Wenting LU
1
;
Xueyi WANG
1
;
Ning LI
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;
Adults;
H 1 coil;
Bilateral dorsolateral prefrontal cortex;
Deep Theta burst stimulation;
Depressive symptoms;
Executive func
- From:
Chinese Journal of Psychiatry
2025;58(9):701-709
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effects of the deep Theta burst stimulation (dTBS) applied to the bilateral dorsolateral prefrontal cortex on depressive symptoms and executive functions in patients with depression.Methods:The clinical data of a total of 98 patients with depression who were outpatients and inpatients in the Mental Health Center of the First Hospital of Hebei Medical University from June 2023 to October 2024 were prospectively collected, including 37 males and 61 females, aged 18-65 (37.4±13.3) years. Patients were randomly assigned to one of three groups: an active dTBS+drug therapy group (active stimulation group, n=33), a sham dTBS+drug therapy group (sham stimulation group, n=32), and a drug therapy group ( n=33). A shielding cover was added over the sham dTBS coil to increase the distance between the coil and the cortical surface, thereby achieving the sham stimulation effect. During each treatment, both active and sham dTBS were first applied by 1, 200 pulses of intermittent dTBS (diTBS) to the left dorsolateral prefrontal cortex, followed by 600 pulses of continuous dTBS (dcTBS) to the right dorsolateral prefrontal cortex. Before treatment and two weeks after treatment, the Hamilton Anxiety Scale (HAMA) and 17-Item Hamilton Depression Scale (HAMD 17) were used to evaluate patients′ depression and anxiety, and the Symbol Digit Coding Test of the Chinese Brief Cognitive Test (C-BCT) was used to assess the executive functions. The 32-item Hypomania Checklist (HCL-32) as well as the Mood Disorder Questionnaire (MDQ) were used to evaluate the risk of treatment-emergent mania. The primary outcomes included reduction rate in HAMD 17 and HAMA scores, as well as changes in the Symbol Digit Coding Test of the C-BCT. Secondary outcomes encompassed HAMD 17 treatment response rate, adverse events, and the risk of treatment-emergent mania. The differences in efficacy between the three groups were compared using one-way ANOVA and LSD post-hoc analysis (reduction rate in HAMD 17 scores, reduction rate in HAMA scores, and changes in the Symbol Digit Coding Test of the C-BCT). Results:At the end of the 2nd week of the treatment, the HAMD 17 reduction rate in the active stimulation group was higher than the sham stimulation group and the drug therapy group, with a significant difference (59.4 (46.9, 80.2) % vs 47.6 (31.2, 58.3) %, H=18.95, P=0.006; 59.4 (46.9, 80.2) % vs 35.5 (20.0, 50.0) %, H=31.10, P<0.001). The HAMA reduction rate in the active stimulation group and the sham stimulation group were higher than the drug therapy group, with a significant difference (52.6 (43.5, 65.7) % vs 2.1 (21.1, 58.8) %, H=21.31, P=0.002; 52.9 (41.7, 62.5) % vs 32.1 (21.1, 58.8) %, H=14.4, P=0.037). The changes in the symbol digit coding test of the C-BCT in the active stimulation group were significantly higher than the sham stimulation group and the drug therapy group (6.3±2.1 scores vs 2.9±3.2 scores, F=5.02, P=0.011; 6.3±2.1 scores vs 2.8±3.1 scores, F=5.02, P=0.009). The incidence rate of adverse events in the active stimulation group was 12.1% (4/33) and 3.1% (1/32) in the sham stimulation group, and there was no significant difference in the incidence of adverse events between the two groups (χ 2=0.17, P=0.355). Conclusion:Bilateral dTBS stimulation of the dorsolateral prefrontal cortex combined with drug therapy can improve depressive symptoms and executive functions, such as information processing speed, attention and working memory.
