Abstract：
Executive function deficits (EFD) in late life depression (LLD) are associated with poor outcomes. Dysfunction of the cognitive control network (CCN) has been posited in the pathophysiology of LLD with EFD.
Seventeen older adults with depression and EFD were randomized to iTBS or sham for 6 weeks. Intervention was delivered bilaterally using a recognized connectivity target.
A total of 89% (17/19) participants completed all study procedures. No serious adverse events occurred. Pre to post-intervention change in mean Montgomery-Asberg-depression scores was not different between iTBS or sham, p = 0.33. No significant group-by-time interaction for Montgomery-Asberg Depression rating scale scores (F 3, 44 = 0.51; p = 0.67) was found. No significant differences were seen in the effects of time between the two groups on executive measures: Flanker scores (F 1, 14 = 0.02, p = 0.88), Dimensional-change-card-sort scores F 1, 14 = 0.25, p = 0.63, and working memory scores (F 1, 14 = 0.98, p = 0.34). The Group-by-time interaction effect for functional connectivity (FC) within the Fronto-parietal-network was not significant (F 1, 14 = 0.36, p = 0.56). No significant difference in the effect-of-time between the two groups was found on FC within the Cingulo-opercular-network (F 1, 14 = 0, p = 0.98).
Bilateral iTBS is feasible in LLD. Preliminary results are unsupportive of efficacy on depression, executive function or target engagement of the CCN. A future Randomized clinical trial requires a larger sample size with stratification of cognitive and executive variables and refinement in the target engagement.
Seventeen older adults with depression and EFD were randomized to iTBS or sham for 6 weeks. Intervention was delivered bilaterally using a recognized connectivity target.
A total of 89% (17/19) participants completed all study procedures. No serious adverse events occurred. Pre to post-intervention change in mean Montgomery-Asberg-depression scores was not different between iTBS or sham, p = 0.33. No significant group-by-time interaction for Montgomery-Asberg Depression rating scale scores (F 3, 44 = 0.51; p = 0.67) was found. No significant differences were seen in the effects of time between the two groups on executive measures: Flanker scores (F 1, 14 = 0.02, p = 0.88), Dimensional-change-card-sort scores F 1, 14 = 0.25, p = 0.63, and working memory scores (F 1, 14 = 0.98, p = 0.34). The Group-by-time interaction effect for functional connectivity (FC) within the Fronto-parietal-network was not significant (F 1, 14 = 0.36, p = 0.56). No significant difference in the effect-of-time between the two groups was found on FC within the Cingulo-opercular-network (F 1, 14 = 0, p = 0.98).
Bilateral iTBS is feasible in LLD. Preliminary results are unsupportive of efficacy on depression, executive function or target engagement of the CCN. A future Randomized clinical trial requires a larger sample size with stratification of cognitive and executive variables and refinement in the target engagement.
摘要：
背景：晚期抑郁症（LLD）中的执行功能缺陷（EFD）与不良预后相关。认知控制网络（CCN）的功能障碍已被认为是具有EFD的LLD的病理生理学。
方法：17名患有抑郁症和EFD的老年人随机接受iTBS或假手术，为期6周。使用公认的连接目标进行双边干预。
结果：共有89%（17/19）的参与者完成了所有研究程序。无严重不良事件发生。干预前后蒙哥马利-阿斯伯格抑郁平均评分的变化在iTBS或假手术之间没有差异，p=0.33。Montgomery-Asberg抑郁量表评分（F3，44=0.51；p=0.67）没有发现明显的分组时间相互作用。两组的时间对执行措施的影响没有显着差异：Flanker评分（F1，14=0.02，p=0.88），维度变化卡片分类得分F1，14=0.25，p=0.63，工作记忆得分（F1，14=0.98，p=0.34）。Fronto顶叶网络内功能连接（FC）的分组时间相互作用效应不显着（F1，14=0.36，p=0.56）。在Cingulo-opulcular-network中，两组之间的时间效应没有显着差异（F1，14=0，p=0.98）。
结论：双侧iTBS在LLD中是可行的。初步结果不支持抑郁症的疗效，CCN的执行功能或目标参与。未来的随机临床试验需要更大的样本量，对认知和执行变量进行分层，并细化目标参与度。
方法：17名患有抑郁症和EFD的老年人随机接受iTBS或假手术，为期6周。使用公认的连接目标进行双边干预。
结果：共有89%（17/19）的参与者完成了所有研究程序。无严重不良事件发生。干预前后蒙哥马利-阿斯伯格抑郁平均评分的变化在iTBS或假手术之间没有差异，p=0.33。Montgomery-Asberg抑郁量表评分（F3，44=0.51；p=0.67）没有发现明显的分组时间相互作用。两组的时间对执行措施的影响没有显着差异：Flanker评分（F1，14=0.02，p=0.88），维度变化卡片分类得分F1，14=0.25，p=0.63，工作记忆得分（F1，14=0.98，p=0.34）。Fronto顶叶网络内功能连接（FC）的分组时间相互作用效应不显着（F1，14=0.36，p=0.56）。在Cingulo-opulcular-network中，两组之间的时间效应没有显着差异（F1，14=0，p=0.98）。
结论：双侧iTBS在LLD中是可行的。初步结果不支持抑郁症的疗效，CCN的执行功能或目标参与。未来的随机临床试验需要更大的样本量，对认知和执行变量进行分层，并细化目标参与度。
