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加快间歇性甲突发刺激和治疗阻抗双极性抑郁症:一项随机临床试验

Yvette I Sheline¹, Walid Makhoul¹, Alexandra S Batzdorf¹

¹Center for Neuromodulation in Depression and Stress, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.

JAMA psychiatry

|July 10, 2024

概括

加速间歇性甲基突发刺激 (aiTBS) 在耐治疗双相情感障碍 (BD) 患者中显著降低了抑郁症状. 这种新的治疗方法为BD中耐火性抑郁症的管理提供了一个有希望的选择.

科学领域:

神经科学是一个神经科学.
精神病学是一个精神病学.
临床试验临床试验

背景情况:

双极性障碍 (BD) 是一种慢性,残疾的疾病,其中抑郁症是主要特征.
治疗耐药性抑郁症在BD中仍然是一个重要的临床挑战.
加快间歇性甲基突发刺激 (aiTBS) 已在治疗耐药性重度抑郁症 (MDD) 中显示出有效性.

研究的目的:

评估aiTBS在治疗治疗不耐治疗的双极性抑郁症患者中的有效性.
评估aiTBS作为一个潜在的治疗选择,为患者群体有限的治疗选择.

主要方法:

一项随机临床试验涉及24名参与者,患有耐治疗性BD和中度至重度抑郁情节.
参与者接受了主动或假aiTBS,以个性化的功能性MRI准为指导.
主要结局指标是治疗前后蒙哥马利-阿斯伯格抑郁评分表 (MADRS) 评分的变化.

主要成果:

与假刺激相比,积极的aiTBS显示MADRS得分在统计学上显著降低.
活跃的aiTBS组显示,平均MADRS得分从30.4降至10.5,而虚假组则从28.0降至25.3.
一个大的效果大小 (Cohen d = -2.19) 表明与积极的aiTBS一起显著减少抑郁症状.

结论:

aiTBS是一种有效的治疗方法,可减少治疗耐药双相情感障碍患者的抑郁症状.
需要进一步的研究来探索aiTBS效应的持久性及其与其他治疗方法的比较有效性.

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