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A pilot investigation of accelerated deep transcranial magnetic stimulation protocols in treatment-resistant depression.
European Archives of Psychiatry and Clinical Neuroscience ( IF 4.7 ) Pub Date : 2020-05-24 , DOI: 10.1007/s00406-020-01141-y
Igor Filipčić 1, 2, 3 , Ivona Šimunović Filipčić 4 , Strahimir Sučić 1 , Željko Milovac 1 , Natko Gereš 1 , Katarina Matić 1 , Mirela Čelić-Ružić 1 , Sandra Zečević Penić 1 , Ivana Orgulan 1 , Vladimir Požgaj 1 , Žarko Bajić 1
Affiliation  

Accelerated repetitive transcranial magnetic stimulation (rTMS) protocols are being increasingly studied because of their potential to provide quicker and enhanced treatment efficacy. However, there is a lack of accelerated deep TMS with H1-coil (adTMS) treatment research. This randomized pilot study investigated the efficacy and safety of adTMS protocols. Twenty-eight TRD patients received 20-min sessions twice daily for 10 or 15 days. Primary outcomes were changes in Hamilton Depression Rating Scale (HDRS) scores and discontinuation because of adverse events (AE). Secondary outcomes were response, remission, daily changes in Beck Depression Inventory-II (BDI-II) scores, and AE incidence. HDRS scores decreased by 13 (95% CI 11-17; 59%, 95% CI 45-73%) and 13 (95% CI 11-14; 62%, 95% CI 54-69%) points in the 10- and 15-day protocols, respectively. The adjusted difference between the two protocols was not significant or clinically relevant. Remission was achieved by 38% and 42% after 10-day and 15-day protocols, respectively. The intervention was discontinued because of AEs in 3/33 (9%) patients. The BDI-II decreases were significant and clinically relevant during the first 8 days. Twice-daily adTMS for 10 days seems to be safe and effective, with rapid clinical benefits during the first week of treatment. These promising results warrant further investigation in larger randomized clinical trials comparing adTMS with the standard dTMS protocol.

中文翻译:

在难治性抑郁症中加速深部经颅磁刺激方案的初步研究。

加速重复经颅磁刺激 (rTMS) 方案的研究越来越多,因为它们有可能提供更快和增强的治疗效果。然而,缺乏加速深部 TMS 与 H1 线圈 (adTMS) 治疗研究。这项随机试验研究调查了 adTMS 协议的有效性和安全性。28 名 TRD 患者每天两次接受 20 分钟的治疗,持续 10 或 15 天。主要结果是汉密尔顿抑郁量表 (HDRS) 评分的变化和因不良事件 (AE) 而停药。次要结果是缓解、缓解、贝克抑郁量表-II (BDI-II) 评分的每日变化和 AE 发生率。在 10-10 分中,HDRS 评分降低了 13(95% CI 11-17;59%、95% CI 45-73%)和 13(95% CI 11-14;62%、95% CI 54-69%)点和 15 天的协议,分别。两种方案之间的调整差异不显着或临床相关。在 10 天和 15 天方案后,缓解率分别为 38% 和 42%。3/33 (9%) 的患者因 AE 而停止干预。在最初的 8 天内,BDI-II 的下降是显着的并且具有临床意义。连续 10 天每天两次 adTMS 似乎是安全有效的,在治疗的第一周内具有快速的临床益处。这些有希望的结果值得在比较 adTMS 与标准 dTMS 协议的较大随机临床试验中进一步研究。在最初的 8 天内,BDI-II 的下降是显着的并且具有临床意义。连续 10 天每天两次 adTMS 似乎是安全有效的,在治疗的第一周内具有快速的临床益处。这些有希望的结果值得在比较 adTMS 与标准 dTMS 协议的较大随机临床试验中进一步研究。
更新日期:2020-05-24
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