Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Aug 19, 2024; 14(8): 1216-1223
Published online Aug 19, 2024. doi: 10.5498/wjp.v14.i8.1216
Alzheimer's disease with depressive symptoms: Clinical effect of intermittent theta burst stimulation repetitive transcranial magnetic stimulation
Xin Jin, Chun-Yun Xu, Jin-Feng Fei, Yu Fang, Cong-Hao Sun
Xin Jin, Chun-Yun Xu, Jin-Feng Fei, Yu Fang, Cong-Hao Sun, Department of Psychiatry, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China
Author contributions: Jin X designed and conducted the research; Sun CH designed and supervised the research; Xu CY, Fei JF, and Fang Y collected and analyzed the data; All authors approved the manuscript.
Supported by Huzhou Science and Technology Plan Project, No. 2019GZ38.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Boards of Huzhou Third Municipal Hospital and the Affiliated Hospital of Huzhou University.
Informed consent statement: All study participants or their legal guardians provided written informed consent for personal and medical data collection before study enrolment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: This dataset is available from the corresponding author. Participants provided informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cong-Hao Sun, MBBS, Attending Doctor, Department of Psychiatry, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, No. 2088 Tiaoxi Dong Road, Huzhou 313000, Zhejiang Province, China. horensu@163.com
Received: June 17, 2024
Revised: July 15, 2024
Accepted: July 17, 2024
Published online: August 19, 2024
Processing time: 55 Days and 20.6 Hours
Abstract
BACKGROUND

Alzheimer's disease (AD), characterized by the ongoing deterioration of neural function, often presents alongside depressive features and greatly affects the quality of life of individuals living with the condition. Although several treatment methods exist, their efficacy is limited. In recent years, repetitive transcranial magnetic stimulation (rTMS) utilizing the theta burst stimulation (TBS) mode, specifically the intermittent TBS (iTBS), has demonstrated promising therapeutic potential in the management of neuropsychiatric disorders.

AIM

To examine the therapeutic efficacy of iTBS mode of rTMS for treating depressive symptoms in patients with AD.

METHODS

This retrospective study enrolled 105 individuals diagnosed with AD with depressive symptoms at Huzhou Third Municipal Hospital, affiliated with Huzhou University, between January 2020 and December 2023. Participants received standard pharmacological interventions and were categorized into control (n = 53) and observation (n = 52) groups based on treatment protocols. The observation group received iTBS mode of rTMS, while the control group received pseudo-stimulation. A comparative analysis evaluated psychological well-being, adverse events, and therapeutic at initiation of hospitalization (T0) and 15 days post-treatment (T1).

RESULTS

At T1, both groups exhibited a marked reduction in self-rating depression scale and Hamilton depression scale scores compared to T0. Furthermore, the observation group showed a more pronounced decrease than the control group. By T1, the Mini-mental state examination scores for both groups had increased markedly from their initial T0 assessments. Importantly, the increase was particularly more substantial in the observation group than in the control group. Fourteen patients in the control group had ineffective treatment effects, while five patients in the observation group experienced the same. Additionally, the observation group experienced a substantially reduced incidence of ineffective treatment as compared to the control group (both P < 0.05); there were no recorded serious adverse events in either group.

CONCLUSION

The iTBS model of rTMS effectively treated AD with depression, improving depressive symptoms and cognitive function in patients without serious adverse reactions, warranting clinical consideration.

Keywords: Alzheimer's disease; Non-persistent θ short array fast pulse mode; Depression; Clinical efficacy; Dementia; Repetitive transcranial magnetic stimulation

Core Tip: Alzheimer's disease (AD) predominantly impacts brain neurons, being a chronic neurodegenerative condition. With disease progression, many patients with AD experience depressive symptoms, significantly impeding their lives while imposing a substantial strain on families and society. Therefore, this study investigated the clinical effects of repetitive transcranial magnetic stimulation-intermittent theta burst stimulation (iTBS-rTMS) on patients with AD experiencing depressive symptoms. Our findings suggest iTBS-rTMS significantly improves depressive symptoms and shows promise in enhancing cognitive function, offering a novel approach to managing comorbid depression in patients with AD and promoting the development of the field of neuroscience.