Procognitive Effects of Adjunctive D-Cycloserine to Intermittent Theta-Burst Stimulation in Major Depressive Disorder: Effets procognitifs de la D-cyclosérine en traitement complémentaire par la stimulation thêta-burst intermittente dans le trouble dépressif caractérisé.

IF 3.3 3区 医学 Q2 PSYCHIATRY
Marilena M DeMayo, Jaeden Cole, Myren N Sohn, Signe L Bray, Ashley D Harris, Scott B Patten, Alexander McGirr
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引用次数: 0

Abstract

Objective: Major depressive disorder (MDD) is associated with cognitive impairments that persist despite successful treatment. Transcranial magnetic stimulation is a noninvasive treatment for MDD that is associated with small procognitive effects on working memory and executive function. We hypothesized that pairing stimulation with N-methyl-D-aspartate (NMDA) receptor agonism would enhance the effects of stimulation and its procognitive effects.

Method: The effect of NMDA receptor agonism (D-cycloserine, 100 mg) on cognitive performance was tested in two randomized double-blind placebo-controlled trials: (1) acute effects of in the absence of stimulation (n = 20 healthy participants) and (2) a treatment study of individuals with MDD (n = 50) randomized to daily intermittent theta-burst stimulation (iTBS) with placebo or D-cycloserine for 2 weeks. Cognitive function was measured using the THINC-it battery, comprised of the Perceived Deficits Questionnaire, the Choice Reaction Time, the Trail Making Test, the Digit Symbol Substitution Test, and the 1-Back tests.

Results: D-cycloserine had no acute effect on cognition compared to placebo. iTBS + D-cycloserine was associated with significant improvements in subjective cognitive function and correct responses on the 1-Back when compared to iTBS + placebo. Improvements in subjective cognition paralleled depressive symptoms improvement, however 1-Back improvements were not attributable to improvement in depression.

Conclusions: An intersectional strategy pairing iTBS with NMDA receptor agonism may restore cognitive function in MDD.

间歇性θ-猝发刺激辅助D-环丝氨酸对重度抑郁障碍的前认知效应
目的:重度抑郁症(MDD)与认知障碍有关,尽管治疗成功,但认知障碍仍然存在。经颅磁刺激是一种治疗重度抑郁症的非侵入性疗法,对工作记忆和执行功能具有微小的认知效应。我们假设,将刺激与 N-甲基-D-天冬氨酸(NMDA)受体激动配对会增强刺激的效果及其认知效应:在两项随机双盲安慰剂对照试验中测试了NMDA受体激动剂(D-环丝氨酸,100毫克)对认知能力的影响:(1) 在无刺激情况下的急性效应(n = 20名健康参与者);(2) MDD患者(n = 50名)的治疗研究,这些患者被随机分配到每天使用安慰剂或D-环丝氨酸进行间歇性θ-爆发刺激(iTBS),为期2周。认知功能采用 THINC-it 电池组进行测量,该电池组由感知缺陷问卷、选择反应时间、路径制作测试、数字符号替换测试和 1-Back 测试组成:与 iTBS + 安慰剂相比,iTBS + D-cycloserine 可显著改善主观认知功能和 1-Back 测试的正确反应。主观认知能力的改善与抑郁症状的改善同步,但1-Back的改善并不能归因于抑郁症状的改善:iTBS与NMDA受体激动剂配对的交叉策略可恢复MDD患者的认知功能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.00
自引率
2.50%
发文量
69
审稿时长
6-12 weeks
期刊介绍: Established in 1956, The Canadian Journal of Psychiatry (The CJP) has been keeping psychiatrists up-to-date on the latest research for nearly 60 years. The CJP provides a forum for psychiatry and mental health professionals to share their findings with researchers and clinicians. The CJP includes peer-reviewed scientific articles analyzing ongoing developments in Canadian and international psychiatry.
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