难治性晚期抑郁症患者的认知特征及其对治疗结果的影响》（Cognitive Profiles in Treatment-Ristant Late-Life Depression and their Impact on Treatment Outcomes.

IF 8.3 2区材料科学 Q1 MATERIALS SCIENCE, MULTIDISCIPLINARY

ACS Applied Materials & Interfaces Pub Date : 2024-11-01 DOI:10.1016/j.bpsc.2024.07.009

Katharina Göke , Shawn M. McClintock , Linda Mah , Tarek K. Rajji , Hyewon H. Lee , Sean M. Nestor , Jonathan Downar , Yoshihiro Noda , Zafiris J. Daskalakis , Benoit H. Mulsant , Daniel M. Blumberger

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引用次数: 0

摘要

背景：晚期抑郁症（LLD）与认知障碍有关，但患者之间存在很大的异质性。有关认知障碍程度的数据尚无定论，尤其是在耐药性抑郁症（TRD）患者中。我们研究了耐药性 LLD 患者与非耐药性 LLD 患者的认知概况，旨在确定不同的认知亚群。此外，我们还研究了认知亚组是否对双侧重复经颅磁刺激（rTMS）治疗有不同的反应。方法：165 名 LLD 患者被分为治疗耐受组和非耐受组，并与健康对照组（HC）在执行功能、信息处理速度、言语学习和记忆方面进行了比较。聚类分析根据认知评分确定了亚组。对认知亚组之间的人口统计学和临床变量以及双侧经颅磁刺激的结果进行了比较：结果：LLD患者，尤其是TRD患者的认知表现明显差于HC患者。研究发现了一种三群组解决方案，包括 "认知完整"（89 人）、"认知减退"（29 人）和 "记忆受损"（47 人）亚群组。与 "认知功能完整 "组相比，"认知功能减退 "和 "记忆力受损 "亚组的焦虑症状更多，TRD患者的比例更高，但后者未能通过多重比较校正。经颅磁刺激治疗的结果无明显差异：结论：LLD患者在各个认知领域都存在障碍，这在TRD患者中更为明显。三个已确定的认知亚组对经颅磁刺激治疗的反应相似，这表明经颅磁刺激治疗对各种认知状况都有效，尤其是在不能耐受药物治疗的情况下。未来的研究应探讨认知亚组、认知功能衰退和神经变性之间的关系。

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Cognitive Profiles in Treatment-Resistant Late-Life Depression and Their Impact on Treatment Outcomes

Background

Late-life depression (LLD) is associated with cognitive impairment, but substantial heterogeneity exists among patients. Data on the extent of cognitive impairments are inconclusive, particularly in patients with treatment-resistant depression (TRD). We investigated the cognitive profiles of patients with treatment-resistant versus nonresistant LLD and aimed to identify distinct cognitive subgroups. We also examined whether cognitive subgroups responded differentially to treatment with bilateral repetitive transcranial magnetic stimulation (rTMS).

Methods

A total of 165 patients with LLD were divided into treatment-resistant and nonresistant groups and compared with healthy control participants on measures of executive function, information processing speed, verbal learning, and memory. Cluster analysis identified subgroups based on cognitive scores. Demographic and clinical variables, as well as outcomes with bilateral rTMS, were compared between cognitive subgroups.

Results

Patients with LLD, particularly TRD, exhibited significantly worse cognitive performance than healthy controls. A 3-cluster solution was found, including cognitively intact (n = 89), cognitively diminished (n = 29), and impaired memory (n = 47) subgroups. Both the cognitively diminished and impaired memory subgroups had more anxiety symptoms and a higher proportion of patients with TRD than the cognitively intact group, although the latter difference did not survive multiple comparison correction. No significant differences were observed in outcomes to rTMS treatment.

Conclusions

Patients with LLD exhibited impairments across cognitive domains, which were more pronounced in TRD. Three cognitive subgroups responded similarly to rTMS treatment, indicating its effectiveness across cognitive profiles, especially when medications are not tolerated. Future research should examine the relationships among cognitive subgroups, cognitive decline, and neurodegeneration.

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来源期刊

ACS Applied Materials & Interfaces 工程技术-材料科学：综合

CiteScore

16.00

自引率

6.30%

发文量

4978

审稿时长

1.8 months

期刊介绍： ACS Applied Materials & Interfaces is a leading interdisciplinary journal that brings together chemists, engineers, physicists, and biologists to explore the development and utilization of newly-discovered materials and interfacial processes for specific applications. Our journal has experienced remarkable growth since its establishment in 2009, both in terms of the number of articles published and the impact of the research showcased. We are proud to foster a truly global community, with the majority of published articles originating from outside the United States, reflecting the rapid growth of applied research worldwide.