研究每日接受θ波爆发刺激的重度抑郁症患者主观睡眠评分的变化

Q3 Psychology

Journal of Affective Disorders Reports Pub Date : 2025-05-18 DOI:10.1016/j.jadr.2025.100933

Jennifer Cuda , David Smith , Arthur R. Chaves , Karina L. Fonseca , Jessica Drodge , Stacey Shim , Youssef Nasr , Maya El-Outa , Ram Brender , Ruxandra Antochi , Lisa McMurray , Rebecca Robillard , Sara Tremblay

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引用次数: 0

摘要

重度抑郁症通常伴有睡眠障碍，睡眠障碍已被发现会影响抗抑郁治疗的反应。重复经颅磁刺激（rTMS），包括新的优化方案，如θ波爆发刺激（TBS），是治疗难治性抑郁症的有效干预措施，尽管人们对睡眠与这种治疗的抗抑郁效果之间的关系知之甚少。方法66例难治性抑郁症患者接受4 ~ 6周的针对左单侧或双侧背外侧前额叶皮质（DLPFC）的每日TBS治疗。使用汉密尔顿抑郁量表（HRSD-17）测量抑郁严重程度，使用利兹睡眠评估问卷（LSEQ）测量主观睡眠。数据分析采用线性混合模型和Spearman相关。结果stbs显著降低了HRSD-17评分，改善了反映睡眠质量、睡眠觉醒难易程度和清醒后行为的LSEQ量表。抑郁症状的改善与20次和30次TBS后醒来后行为的改善有关，但与睡眠质量无关。局限性局限性包括样本量有限，缺乏假性条件，主观睡眠测量和治疗次数可变（20或30次TBS）。结论TBS治疗可同时改善主观睡眠质量和抑郁症状。此外，抑郁症的变化与与睡眠相关的白天功能的变化密切相关，而不是与睡眠质量本身相关。需要进一步的工作来描述神经调节后的睡眠改善如何有助于抗抑郁反应。

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Examining alterations in subjective sleep ratings in individuals with major depressive disorder receiving daily theta burst stimulation

Background

Major depressive disorder is often accompanied by sleep disturbances, which have been found to influence response to antidepressant treatments. Repetitive transcranial magnetic stimulation (rTMS), including novel optimized protocols like theta burst stimulation (TBS), is an effective intervention for treatment-resistant depression, although little is known about the relationship between sleep and the antidepressant effects of this treatment.

Methods

Sixty-six individuals with treatment-resistant depression received 4 to 6 weeks of daily TBS treatments targeting the left-unilateral or bilateral dorsolateral prefrontal cortex (DLPFC). Depression severity was measured using the Hamilton Rating Scale for Depression (HRSD-17) and subjective sleep using the Leeds Sleep Evaluation Questionnaire (LSEQ). Data was analyzed with linear mixed models and Spearman correlations.

Results

TBS significantly reduced HRSD-17 scores and improved LSEQ subscales reflecting sleep quality, ease of awakening from sleep, and behavior following wakefulness. Improvements in symptoms of depression were associated with improvement in behavior following waking after 20 and 30 TBS sessions, but not with sleep quality.

Limitations

Limitations include a limited sample size, lack of sham condition, subjective measures of sleep and variable number of treatments (20 or 30 TBS sessions).

Conclusions

These findings suggest that TBS treatments concurrently improve subjective sleep quality and depression symptoms. Additionally, changes in depression more closely aligned with changes in sleep-related daytime functioning than with sleep quality per se. Further work is required to delineate how sleep improvements following neuromodulation may contribute to the antidepressant response.

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