背景:恐慌症是临床实践中常见且重要的疾病,会降低个体生产力并增加医疗保健使用。治疗包括药物治疗和认知行为治疗。然而,不良的药物作用和不良的治疗依从性意味着需要新的治疗模式.
目的:我们假设恐慌症的数字化治疗可以改善恐慌症的症状,并且治疗反应与功能近红外光谱(fNIRS)评估的大脑活动变化有关。
方法:招募有惊恐发作史的个体(n=50)。在使用惊恐障碍的应用程序之前和之后评估症状,在这项研究中,这是一个基于智能手机的应用程序,用于治疗恐慌症的临床症状,恐慌症状,抑郁症状,和焦虑。通过fNIRS测量静息状态下额叶皮质的血液动力学。该应用程序有四个部分:日记,教育,quest,严肃的游戏。研究试验获得中安大学医院机构审查委员会的批准(1041078-202112-HR-349-01),并获得所有参与者的书面知情同意书。
结果:应用组恐慌症状改善的参与者人数(20/25,80%)大于对照组(6/21,29%;χ21=12.3;P=0.005)。治疗期间,应用组的惊恐障碍严重程度量表(PDSS)评分改善大于对照组(F1,44=7.03;P=0.01).在应用程序使用组中,总PDSS评分下降了42.5%(基线时平均评分14.3,SD6.5,干预后平均评分7.2,SD3.6),而对照组的PDSS评分下降了14.6%(基线时平均评分12.4,SD5.2,干预后平均评分9.8,SD7.9).在应用和对照组之间,基线时累积的氧合血红蛋白(accHbO2)没有显着差异。治疗期间,在应用中,右腹外侧前额叶皮质(VLPFC;F1,44=8.22;P=.006)和右眶前额叶皮质(OFC;F1,44=8.88;P=.005)的accHbO2降低幅度大于对照组.
结论:应用惊恐障碍可以有效减轻惊恐障碍患者的症状和VLPFC和OFC脑活动。惊恐障碍症状的改善与静息状态下VLPFC和OFC脑活动的降低呈正相关。
背景:临床研究信息服务KCT0007280;https://cris。nih.走吧。kr/cris/search/detailSearch.做?seq=21448。
BACKGROUND: Panic disorder is a common and important disease in clinical practice that decreases individual productivity and increases health care use. Treatments comprise medication and cognitive behavioral therapy. However, adverse medication effects and poor treatment compliance mean new therapeutic models are needed.
OBJECTIVE: We hypothesized that digital therapy for panic disorder may improve panic disorder symptoms and that treatment response would be associated with brain activity changes assessed with functional near-infrared spectroscopy (fNIRS).
METHODS: Individuals (n=50) with a history of panic attacks were recruited. Symptoms were assessed before and after the use of an app for panic disorder, which in this study was a smartphone-based app for treating the clinical symptoms of panic disorder, panic symptoms, depressive symptoms, and anxiety. The hemodynamics in the frontal cortex during the resting state were measured via fNIRS. The app had 4 parts: diary, education, quest, and serious games. The study trial was approved by the institutional review board of Chung-Ang University Hospital (1041078-202112-HR-349-01) and written informed consent was obtained from all participants.
RESULTS: The number of participants with improved panic symptoms in the app use group (20/25, 80%) was greater than that in the control group (6/21, 29%; χ21=12.3; P=.005). During treatment, the improvement in the Panic Disorder Severity Scale (PDSS) score in the app use group was greater than that in the control group (F1,44=7.03; P=.01). In the app use group, the total PDSS score declined by 42.5% (mean score 14.3, SD 6.5 at baseline and mean score 7.2, SD 3.6 after the intervention), whereas the PDSS score declined by 14.6% in the control group (mean score 12.4, SD 5.2 at baseline and mean score 9.8, SD 7.9 after the intervention). There were no significant differences in accumulated oxygenated hemoglobin (accHbO2) at baseline between the app use and control groups. During treatment, the reduction in accHbO2 in the right ventrolateral prefrontal cortex (VLPFC; F1,44=8.22; P=.006) and the right orbitofrontal cortex (OFC; F1,44=8.88; P=.005) was greater in the app use than the control group.
CONCLUSIONS: Apps for panic disorder should effectively reduce symptoms and VLPFC and OFC brain activity in patients with panic disorder. The improvement of panic disorder symptoms was positively correlated with decreased VLPFC and OFC brain activity in the resting state.
BACKGROUND: Clinical Research Information Service KCT0007280; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=21448.