| Summary: | 碩士 === 中山醫學大學 === 心理學系暨臨床心理學碩士班 === 104 === Background: Repetitive transcranial magnetic stimulation (rTMS) on Dorsal Lateral Prefrontal Cortex (DLPFC) has been used increasingly as an alternative therapy for patients with major depressive disorder(MDD). Recently development of Theta-burst stimulation (TBS) requires less stimulation time and intensity to induce longer effects. Due to the DLPFC serve the functions to cognitive integration and emotional regulation, it is important to evaluate cognitive function while adopt TBS therapy on MDD patients.
Purpose: This research aims to assess the cognitive function after TBS therapy in MDD patients with specially focus on working memory.
Method: Twenty MDD patients recruited and were randomly assigned in sham-controlled trial with double-blinded control protocol. Participants in patient groups received 10-session bilateral active or sham TBS intervention on left and right DLPFC within week 1 to week 4. Twenty-Seven health adults recruited as age-matched control group. All groups of participants received a series of assessments and cognitive task at week 0, 1, 4, and 24. These assessments included the Mini Mental State Examination (MMSE), the 21-item Hamilton Rating Scale for Depression (HAMD-21), the Beck Depression Inventory II (BDI-II), and digit span test. The n-back task was adopted to evaluate participants’ working memory. Participants were asked to perform n-back with 0, 1, 2 levels of memory load manipulation..
Results & Discussions: The HAMD-21 scores of TBS-treated group were significantly decreased than TBS-sham group at week 4 (p=0.021) and week 24 (p=0.007). There were no significantly difference between TBS-treated group and TBS-sham group in MMSE, forward and backward digit memory tests. Results of n-back task shows that the reaction time of TBS-treated group were significantly shorter than TBS-sham group in 0-back at week 1 (p=0.05) and week 4 (p=0.043); in 1-back at week 4 (p=0.048) and week 24 (p=0.002); and in 2-back at week 4 (p=0.005) and week 24 (p=0.046).
Conclusion: This randomized sham-controlled study demonstrated that active theta-burst stimulation produced good antidepressant efficacy. Furthermore, the reaction time of the n-back working memory task significantly improved along the TBS treatments. According to this study, TBS treatment not only improved the symptoms of MDD, but also improved the working memory reaction time.
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