背景:在重度抑郁症(MDD)的治疗中观察到性别和年龄依赖性结果差异,包括10Hz重复经颅磁刺激(rTMS)。我们检查了间歇性Theta爆发刺激(iTBS)的结局是否存在性别和年龄依赖性差异,另一个rTMS协议。
方法:生物性别之间的关系,年龄,回顾性分析了414例用10Hz或iTBSrTMS治疗的MDD患者的治疗结果。线性混合效应模型用于检查治疗与30项抑郁症状自我报告量表(IDS-SR30)评分从基线到治疗10和30的变化之间的关联,以及生物学性别(M/F)。协议(iTBS/10Hz),年龄(≥/<50岁),和时间(治疗1/10/30)作为固定效应。使用三种性别-协议-时间和年龄-协议-时间相互作用来确定协议与结果之间的任何差异关系,具体取决于性别和年龄。进行事后t检验以检查改进方面的差异。
结果:在治疗10(p=0.016)和30(p=0.031)时,存在明显的三种性别-方案-时间相互作用。在处理10(p=0.041)和30(p=0.035)时,雄性iTBS的改善显着大于雌性。而女性在10Hz治疗下显示出数字上更大的改善。虽然没有显著的三方年龄-协议-时间互动,年龄(≥50岁)和治疗时间10(p=0.007)和30(p=0.042)之间存在显着的相互作用,在年龄上,性别,和治疗时间30(p=0.028)。
结论:回顾性自然治疗方案。
结论:iTBS在女性中的疗效低于男性,在50岁以上的患者中,rTMS总体上更有效,尤其是女性。
BACKGROUND: Sex- and age-dependent outcome differences have been observed in treatment of Major Depressive Disorder (MDD), including 10 Hz repetitive Transcranial Magnetic Stimulation (rTMS). We examined whether there are sex- and age-dependent differences in outcome with intermittent Theta Burst Stimulation (iTBS), another rTMS protocol.
METHODS: The relationship between biological sex, age, and treatment outcome was retrospectively examined among 414 patients with MDD treated with 10 Hz or iTBS rTMS. Linear mixed-effects modeling was used to examine the association between treatment and change in the 30-item Inventory of Depressive Symptomatology Self-Report (IDS-SR30) score from baseline to treatments 10 and 30, with biological sex (M/F), protocol (iTBS/10 Hz), age (≥/<50 years old), and time (treatment 1/10/30) included as fixed effects. The three-way sex-protocol-time and age-protocol-time interactions were used to determine any differential relationships between protocol and outcome dependent on sex and age. Post-hoc t-tests were conducted to examine differences in improvement.
RESULTS: There was a significant three-way sex-protocol-time interaction at treatments 10 (p = 0.016) and 30 (p = 0.031). Males showed significantly greater improvement with iTBS than females at treatments 10 (p = 0.041) and 30 (p = 0.035), while females showed numerically greater improvement with 10 Hz treatment. While there was not a significant three-way age-protocol-time interaction, there was a significant interaction between age (≥50 years old) and time at treatments 10 (p = 0.007) and 30 (p = 0.042), and among age, sex, and time at treatment 30 (p = 0.028).
CONCLUSIONS: Retrospective naturalistic treatment protocol.
CONCLUSIONS: iTBS appeared less efficacious in females than in males, and rTMS overall was more efficacious in patients over fifty, particularly females.