同病性通用焦虑障碍对rTMS/iTBS重大抑郁症临床结果的影响:基于多中心注册表的观察性研究
Yoshihiro Noda1, Ryota Osawa2,3, Yuya Takeda3
1Department of Psychiatry, International University of Health and Welfare, Mita Hospital, Tokyo 108-8329, Japan.
Journal of personalized medicine
|February 26, 2026
概括
重复的横磁刺激 (rTMS) 和间歇性甲爆刺激 (iTBS) 有效地治疗主要抑郁症 (MDD),即使是并发性泛性焦虑症 (GAD). 治疗结果在各组之间是可比的,药物或刺激类型没有显著的影响.
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.
- 临床治疗学 临床治疗学
背景情况:
- 重度抑郁症 (MDD) 经常与泛性焦虑症 (GAD) 一起发生,增加了疾病负担.
- 重复性横磁刺激 (rTMS) 和间歇性甲爆刺激 (iTBS) 是FDA批准的治疗MDD.
- 伴并发性GAD和并发药物对MDD的rTMS/iTBS结果的影响还不清楚.
研究的目的:
- 为了比较rTMS/iTBS治疗结果,在MDD患者与并发性GAD和没有并发性GAD.
- 调查心理药物使用和刺激方案对治疗反应的影响.
- 在现实临床环境中评估治疗的有效性.
主要方法:
- 对108名患者 (36名MDD+GAD,仅72名MDD) 的注册表数据进行了回顾性分析.
- 患者接受左侧iTBS或右侧rTMS.
- 评估了基线严重程度,MADRS和HAMD-17得分变化,反应和缓解率,使用回归模型和灵敏度分析 (按协议和二胺使用分层).
主要成果:
- 在MDD+GAD和MDD-only组之间,基线严重程度,反应或缓解率没有显著差异.
- 在MDD+GAD组中,MADRS的减少数量较低 (48.3%对52.7%),但HAMD-17的减少相当.
- 同时服用药物和刺激方案并没有显著影响结果;二二胺使用者显示出较低MADRS改善的非显著趋势.
结论:
- rTMS/iTBS证明了MDD的实质性临床改善和耐受性,有或没有并发性GAD.
- 伴并发性GAD对MADRS改善的减少趋势适度,但没有影响整体反应或缓解率.
- 进一步调查二对治疗结果的潜在影响是有必要的.
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