Učinak ponavljajuće transkranijske magnetske stimulacije H1 kacigom na beznađe u bolesnika s velikim depresivnim poremećajem

doctoral thesis

• Title (english): The effect of repetitive transcranial magnetic stimulation with H1 coil on hopelessness in patients with major depressive disorder
• Author: Tomislav Gajšak
• Mentor: Zoran Zoričić (mentor)
• Committee member: Ana Matošić (predsjednik povjerenstva)
• Committee member: Zlatko Trkanjec (član povjerenstva)
• Committee member: Rudolf Gregurek (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Chair of Psychiatry and Medical Psychology); Zagreb
• Defense date and country: 2024-10-22, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Psychiatry
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Cilj istraživanja bio je ispitati učinkovitost duboke ponavljajuće transkranijske magnetske stimulacije (dTMS) H1-zavojnicom uz standardnu terapiju beznađa kod velikog depresivnog poremećaja (VDP). Proveli smo randomizirano kontrolirano ispitivanje bez kontrole lažnom zavojnicom u tercijarnoj psihijatrijskoj ustanovi u Hrvatskoj na uzastopnom uzorku pacijenata s dijagnosticiranim velikim depresivnim poremećajem (VDP) bez psihotičnih simptoma i s klinički relevantnim beznađem. Intervencija je bila dTMS s H1-zavojnicom koja stimulira lijevi DLPFC visokom frekvencijom (18 Hz) tijekom četiri tjedna. Ishod je bio promjena rezultata
Beckove ljestvice beznađa (engl. Beck Hopelessness Scale; BHS) u bolesnika predviđenih za liječenje (engl. intention-to-treat). Rezultati: Randomizirali smo 51 sudionika u intervencijsku skupinu (dTMS uz standardnu terapiju) i 52 u kontrolnu skupinu (uobičajeno liječenje). Prosječna dob bila je 50 (standardna devijacija; SD 12,3) godina i 50 (SD 10,4) godina, respektivno 47 % i 52 % žena. U bivarijatnoj, neprilagođenoj analizi razlika u smanjenju rezultata BHS-a bila je značajna (p = 0,043; stopa lažnog otkrića (FDR) > 5 %). U multivarijabilnoj analizi, rezultat BHS-a smanjen je za 10,8 % (95 % interval pouzdanosti (CI) -17,8 % do -3,9 %) u skupini s dTMS-om, a samo 0,7 % (95 % CI -7,5 % do 6,1 %) u kontrolnoj skupini (p=0,037; FDR < 5 %). Zaključci: Našli smo naznake učinka dTMS-a s H1-zavojnicom na simptom beznađa kod pacijenata dijagnosticiranih s VDP-om.

Abstract (english)

Aim: Assessment of the efficacy of deep repetitive transcranial magnetic stimulation (dTMS) with H1-coil augmented to standard therapy for hopelessness in major depressive disorder (MDD).
Participants and methods: We performed a randomised controlled trial with no sham-coil at a tertiary psychiatric institution in Croatia in a consecutive sample of patients diagnosed with major depressive disorder (MDD) without psychotic symptoms and with clinically relevant hopelessness. The intervention was dTMS with H1-coil stimulating left DLPFC with high frequency (18 Hz) over four weeks. The outcome was a change in the Beck Hopelessness Scale (BHS) score in the intention-to-treat population.
Results: We randomised 51 participants to the intervention group (dTMS augmented to standard therapy) and 52 to the control group (treatment as usual). The mean (SD) age was 50 (12.3), and 50 (10.4) years, 47 % and 52 % were women respectively. The difference in lowering of BHS score in bivariable, unadjusted analysis was significant (p = 0.043; false
discovery rate (FDR) > 5 %). In multivariate analysis, the BHS score was reduced for 10.8 % (95 % confidence interval (CI) - 17.8 % to -3.9 %) in the dTMS, and only 0.7 % (95 % CI -7.5 % to 6.1 %) in the control group (p=0.037; FDR < 5 %).
Conclusion: We have found an indication of the effect of dTMS with H1-coil on hopelessness symptom in patients diagnosed with MDD.

• Keywords: veliki depresivni poremećaj; transkranijska magnetska stimulacija
• Keywords (english): Major Depressive Disorder; Transcranial Magnetic Stimulation
• Language: croatian
• URN:NBN: urn:nbn:hr:127:651053
• Promotion: 2024
• Study programme: Title: Dental medicine; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti u području biomedicine i zdravstva (doktor/doktorica znanosti u području biomedicine i zdravstva)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-10-31 08:12:24