Efficacy of prefrontal theta-burst stimulation in refractory depression: A randomized sham-controlled study

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Title:	Efficacy of prefrontal theta-burst stimulation in refractory depression: A randomized sham-controlled study
Authors:	阮啓弘;Li, Cheng-Ta;Chen, Mu-Hong;Juan, Chi-Hung;Huang, Hsiang-Hsuan;Chen, Li-Fen;Hsieh, Jen-Chuen;Tu, Pei-Chi;Bai, Ya-Mei;Tsai, Shin-Jen;Lee, Ying-Chiao;Su, Tung-Ping
Contributors:	生醫理工學院認知神經科學研究所
Keywords:	Adult;Adult and adolescent clinical studies;Aged;Analysis of Variance;Antidepressive Agents;Antidepressive Agents - therapeutic use;Biological and medical sciences;Depression;Depression - therapy;Double-Blind Method;Female;Follow-Up Studies;Humans;Magnetic Resonance Imaging;Male;Medical sciences;Middle Aged;Miscellaneous;Mood disorders;Multiple sclerosis and variants. Guillain barr� syndrome and other inflammatory polyneuropathies. Leukoencephalitis;Neurology;Psychiatric Status Rating Scales;Psychology. Psychoanalysis. Psychiatry;Psychopathology. Psychiatry;Theta Rhythm;Theta Rhythm - physiology;Transcranial Magnetic Stimulation;Transcranial Magnetic Stimulation - methods;Treatment Outcome;Young Adult
Date:	2014-01-01
Issue Date:	2026-04-23 14:25:39 (UTC+8)
Publisher:	Oxford: Oxford University Press (OUP)
Abstract:	摘要： Theta-burst transcranial magnetic stimulation could modulate cortical excitability and has the potential to treat refractory depression. However, there has been a lack of large randomized studies of the antidepressant efficacy of different forms of theta-burst stimulation, such as intermittent and continuous theta-burst stimulation. A randomized sham-controlled study was conducted to investigate antidepressant efficacy of theta-burst stimulation and to compare efficacy among left-prefrontal intermittent theta-burst stimulation, right-prefrontal continuous theta-burst stimulation and a combination of them in patients showing different levels of antidepressant refractoriness. A group of 60 treatment-refractory patients with recurrent major depressive disorder were recruited and randomized to four groups (Group A: continuous theta-burst stimulation; Group B: intermittent theta-burst stimulation; Group C: a combination of continuous and intermittent theta-burst stimulation; and Group D: sham theta-burst stimulation; 15 patients were included in each group). After 2 weeks of theta-burst stimulation treatment, depression improved in all groups. Groups B and C had better antidepressant responses (as reflected by % decreases in depression score) than Groups A and D (P = 0.001, post hoc analysis: B > A, B > D, C > A, and C > D), even after controlling for age and refractoriness scores. The mean antidepressant effect was highest in Group C and followed by that in Group B. Additionally, a significant placebo effect was found in patients with low refractoriness; this disappeared in patients with moderate-to-high refractoriness. A significant correlation existed between refractoriness scores and treatment responses. Treatment refractoriness was a significant factor negatively predicting efficacy of theta-burst stimulation (P = 0.039). This randomized sham-controlled study demonstrated that active theta-burst stimulation is a well-tolerated form of repetitive transcranial magnetic stimulation and has good antidepressant efficacy, particularly in depressed subjects within a certain range of treatment refractoriness. 其他題名： Brain 出版者： Oxford: Oxford University Press (OUP) 出版日期： 2014-07-01 出處： Brain, 2014-07, Vol.137 (7), p.2088-2098 版權： 2015 INIST-CNRS 版權： The Author (2014). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissionsoup.com. 識別號： ISSN: 0006-8950 識別號： ISSN: 1460-2156 識別號： EISSN: 1460-2156 識別號： DOI: 10.1093/brain/awu109 識別號： PMID: 24817188
Appears in Collections:	[College of Science Institute of Cognitive Neuroscience] journal & Dissertation

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