Efficacy of Adjunctive D-Cycloserine to Intermittent Theta-Burst Stimulation for Major Depressive Disorder

重性抑郁障碍 心理学 安慰剂 磁刺激 内科学 临床全球印象 萧条(经济学) 重性抑郁发作 精神科 医学 刺激 心情 替代医学 病理 经济 宏观经济学
作者
Jaeden Cole,Maya N. Sohn,Ashley D. Harris,Signe Bray,Scott B. Patten,Alexander McGirr
出处
期刊:JAMA Psychiatry [American Medical Association]
卷期号:79 (12): 1153-1153 被引量:51
标识
DOI:10.1001/jamapsychiatry.2022.3255
摘要

The antidepressant effects of transcranial magnetic stimulation protocols for major depressive disorder (MDD) are thought to depend on synaptic plasticity. The theta-burst stimulation (TBS) protocol synaptic plasticity is known to be N-methyl-D-aspartate (NMDA)-receptor dependent, yet it is unknown whether enhancing NMDA-receptor signaling improves treatment outcomes in MDD.To test whether low doses of the NMDA-receptor partial-agonist, D-cycloserine, would enhance intermittent TBS (iTBS) treatment outcomes in MDD.This was a single-site 4-week, double-blind, placebo-controlled, randomized clinical trial conducted from November 6, 2019, to December 24, 2020, including 50 participants with MDD. Participants were recruited via advertisements and referral. Inclusion criteria were as follows: age 18 to 65 years with a primary diagnosis of MDD, a major depressive episode with score of 18 or more on the 17-item Hamilton Depression Rating Scale, a Young Mania Rating Scale score of 8 or less, and normal blood work (including complete blood cell count, electrolytes, liver function tests, and creatinine level).Participants were randomly assigned 1:1 to either iTBS plus placebo or iTBS plus D-cycloserine (100 mg) for the first 2 weeks followed by iTBS without an adjunct for weeks 3 and 4.The primary outcome was change in depressive symptoms as measured by the Montgomery-Åsberg Depression Rating Scale (MADRS) at the conclusion of treatment. Secondary outcomes included clinical response, clinical remission, and Clinical Global Impression (CGI) scores.A total of 50 participants (mean [SD] age, 40.8 [13.4] years; 31 female [62%]) were randomly assigned to treatment groups: iTBS plus placebo (mean [SD] baseline score, 30.3 [4.2]) and iTBS plus D-cycloserine (mean [SD] baseline score, 30.4 [4.5]). The iTBS plus D-cycloserine group had greater improvements in MADRS scores compared with the iTBS plus placebo group (mean difference, -6.15; 95% CI, -2.43 to -9.88; Hedges g = 0.99; 95% CI, 0.34-1.62). Rates of clinical response were higher in the iTBS plus D-cycloserine group than in the iTBS plus placebo group (73.9% vs 29.3%), as were rates of clinical remission (39.1% vs 4.2%). This was reflected in lower CGI-severity ratings and greater CGI-improvement ratings. No serious adverse events occurred.Findings from this clinical trial indicate that adjunctive D-cycloserine may be a promising strategy for enhancing transcranial magnetic stimulation treatment outcomes in MDD using iTBS requiring further investigation.ClinicalTrials.gov Identifier: NCT03937596.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
彦祖i学术完成签到,获得积分10
1秒前
zq完成签到,获得积分20
2秒前
HY完成签到,获得积分10
3秒前
不再挨训完成签到 ,获得积分10
4秒前
学术乞丐完成签到,获得积分20
6秒前
咖啡博士完成签到,获得积分10
7秒前
韭黄发布了新的文献求助10
8秒前
Singularity完成签到,获得积分0
10秒前
JamesPei应助zq采纳,获得10
11秒前
所所应助韭黄采纳,获得10
15秒前
江霭完成签到,获得积分10
18秒前
鲤鱼青槐完成签到,获得积分10
27秒前
量子星尘发布了新的文献求助10
28秒前
31秒前
缥缈的冰旋完成签到,获得积分10
31秒前
37秒前
38秒前
ailemonmint完成签到 ,获得积分10
38秒前
39秒前
玉ER完成签到,获得积分10
40秒前
41秒前
四十四次日落完成签到 ,获得积分10
41秒前
科研通AI2S应助羊二呆采纳,获得10
41秒前
英吉利25发布了新的文献求助10
43秒前
44秒前
水晶茶杯发布了新的文献求助10
45秒前
欢欢完成签到,获得积分10
46秒前
茯苓完成签到 ,获得积分10
48秒前
小鱼发布了新的文献求助10
49秒前
香香丿完成签到 ,获得积分10
49秒前
50秒前
万能图书馆应助zz123采纳,获得10
50秒前
杜康完成签到,获得积分10
50秒前
Cheung2121发布了新的文献求助10
50秒前
医学小王完成签到 ,获得积分10
51秒前
53秒前
刘涵完成签到 ,获得积分10
54秒前
帅气的沧海完成签到 ,获得积分10
55秒前
辣辣辣辣辣辣完成签到 ,获得积分10
58秒前
59秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038112
求助须知:如何正确求助?哪些是违规求助? 3575788
关于积分的说明 11373801
捐赠科研通 3305604
什么是DOI,文献DOI怎么找? 1819255
邀请新用户注册赠送积分活动 892655
科研通“疑难数据库(出版商)”最低求助积分说明 815022