scholarly journals Antidepressant efficacy of low-frequency repetitive transcranial magnetic stimulation in antidepressant-nonresponding bipolar depression: a single-blind randomized sham-controlled trial

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Arthur D. P. Mak ◽  
Sebastiaan F. W. Neggers ◽  
Owen N. W. Leung ◽  
Winnie C. W. Chu ◽  
Jenny Y. M. Ho ◽  
...  
Keyword(s):  
Bipolar Depression ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Trial ◽  
Low Frequency ◽  
Significant Group ◽  
Time Interaction ◽  
Response Predictors ◽  
Antidepressant Efficacy ◽  
Clinical Trials Registry ◽  
Single Blind

Abstract Background To examine the antidepressant efficacy and response predictors of R-DLPFC-LF rTMS for antidepressant-nonresponding BD. Methods We conducted a single-blind randomized sham-controlled trial for 54 (28 sham, 26 active) patients with antidepressant-nonresponding BD (baseline MADRS ≥ 20). Patients received 15 daily sessions of active or sham neuronavigated rTMS (Figure-of-8 coil, five 1 Hz 60 s 110% RMT trains). Outcome measures included depressive response (≥ 50% MADRS reduction, CGI ≤ 2) and remission (MADRS < 7, CGI = 1) rates, treatment emergent hypo/mania (YMRS), depressive and anxiety symptoms (HAM-A). Results 48 patients (25 sham, 23 active) completed treatment, with 3 drop-outs each in active and sham groups. Active rTMS did not produce superior response or remission rates at endpoint or 6 or 12 weeks (ps > 0.05). There was no significant group * time interaction (ps > 0.05) in a multivariate ANOVA with MADRS, HAMA and YMRS as dependent variables. Exploratory analysis found MADRS improvement to be moderated by baseline anxiety (p = 0.02) and melancholia (p = 0.03) at week 3, and depressive onset at weeks 6 (p = 0.03) and 12 (p = 0.04). In subjects with below-mean anxiety (HAMA < 20.7, n = 24), MADRS improvement from active rTMS was superior to sham at week 3 (ITT, t = 2.49, p = 0.04, Cohen’s d = 1.05). No seizures were observed. Groups did not differ in treatment-emergent hypomania (p = 0.1). Limitations Larger sample size might be needed to power subgroup analyses. Moderation analyses were exploratory. Single-blind design. Unblinding before follow-up assessments due to ethical reasons. Conclusions 1-Hz 110% RMT (5 × 60 s trains) R-DLPFC-LF rTMS was not effective for antidepressant non-responding BD but may be further investigated at increased dosage and/or in BD patients with low anxiety. Trial registration CCRB Clinical Trials Registry, CUHK, CUHK_CCT00440. Registered 04 December 2014, https://www2.ccrb.cuhk.edu.hk/registry/public/279

scholarly journals Repetitive transcranial magnetic stimulation in the treatment of bipolar disorder

2020 ◽  
Vol 10 ◽  
pp. 204512532097379
Author(s):  
Danielle Hett ◽  
Steven Marwaha
Keyword(s):  
Bipolar Disorder ◽  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Magnetic Stimulation ◽  
Sleep Problems ◽  
Bipolar Depression ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Trial ◽  
Total N ◽  
Depressive Episodes

Bipolar disorder (BD) is a debilitating mood disorder marked by manic, hypomanic and/or mixed or depressive episodes. It affects approximately 1–2% of the population and is linked to high rates of suicide, functional impairment and poorer quality of life. Presently, treatment options for BD are limited. There is a strong evidence base for pharmacological (e.g., lithium) and psychological (e.g., psychoeducation) treatments; however, both of these pose challenges for treatment outcomes (e.g., non-response, side-effects, limited access). Repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation technique, is a recommended treatment for unipolar depression, but it is unclear whether rTMS is an effective, safe and well tolerated treatment in people with BD. This article reviews the extant literature on the use of rTMS to treat BD across different mood states. We found 34 studies in total ( N = 611 patients), with most assessing bipolar depression ( n = 26), versus bipolar mania ( n = 5), mixed state bipolar ( n = 2) or those not in a current affective episode ( n = 1). Across all studies, there appears to be a detectable signal of efficacy for rTMS treatment, as most studies report that rTMS treatment reduced bipolar symptoms. Importantly, within the randomised controlled trial (RCT) study designs, most reported that rTMS was not superior to sham in the treatment of bipolar depression. However, these RCTs are based on small samples ( NBD ⩽ 52). Reported side effects of rTMS in BD include headache, dizziness and sleep problems. Ten studies ( N = 14 patients) reported cases of affective switching; however, no clear pattern of potential risk factors for affective switching emerged. Future adequately powered, sham-controlled trials are needed to establish the ideal rTMS treatment parameters to help better determine the efficacy of rTMS for the treatment of BD.

Testing the Effectiveness of a Strengths-Based Intervention Targeting All 24 Strengths: Results From a Randomized Controlled Trial

2020 ◽  
pp. 003329412093744
Author(s):  
Lobna Chérif ◽  
Valerie M. Wood ◽  
Christian Watier
Keyword(s):  
Randomized Controlled Trial ◽  
Character Strengths ◽  
Controlled Trial ◽  
Control Group ◽  
Strength Development ◽  
Character Strength ◽  
Significant Group ◽  
Randomized Controlled ◽  
Time Interaction ◽  
Experimental Group

This study assessed the effectiveness of a strengths-based randomized controlled trial focused on fostering all 24 character strengths in a group of 75 participants from a University in Tunisia. Participants randomly assigned to the challenge condition (n = 40) received an email each day for 24 days, that highlighted a particular strength of the day including why the strength is valuable, how to implement the strength behaviourally, and a motto related to that strength. Those in the control condition (n = 35) simply received emails containing the motto for each strength daily for 24 days. We assessed all participants’ levels of happiness before the experiment (T0), the day following the experiment (T1), and one-month following the experiment (T2). Results from a 2 (group) X 3 (time) split plot ANOVA revealed a significant group-by-time interaction, such that at T2 the experimental group had greater happiness scores than the control group. These findings provide some evidence that even “minimalist” interventions (involving the receipt of emails encouraging character-strength development), might be effective for promoting gains in happiness even one month after the intervention.

scholarly journals Cognitive Rehabilitation and Exposure/Sorting Therapy for Late-Life Hoarding: Effects on Neuropsychological Performance

2019 ◽  
Vol 75 (6) ◽  
pp. 1193-1198 ◽  
Author(s):  
Catherine R Ayers ◽  
Eliza J Davidson ◽  
Mary E Dozier ◽  
Elizabeth W Twamley
Keyword(s):  
Older Adults ◽  
Executive Functioning ◽  
Cognitive Rehabilitation ◽  
Care Management ◽  
Neuropsychological Functioning ◽  
Controlled Trial ◽  
Management Control ◽  
Significant Group ◽  
Time Interaction ◽  
Executive Functioning Deficits

Abstract Objectives Hoarding disorder (HD) is characterized by urges to save items, difficulty discarding possessions, and excessive clutter and has been associated with executive functioning deficits. A randomized controlled trial comparing Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST) with a care management control condition demonstrated the efficacy of CREST in reducing hoarding symptoms in older adults. The purpose of the current study was to assess whether CREST may also lead to improved executive functioning. Method All participants were administered a neurocognitive battery at baseline and posttreatment. Linear mixed models with random intercepts were used to evaluate change in global neuropsychological functioning as well as change in individual executive functioning variables. Results There was no significant group by time interaction for the Global Deficit score; however, there were significant group by time interactions on two of the executive functioning variables examined, such that participants in the CREST condition demonstrated significant improvement in cognitive flexibility and inhibition over time compared with the participants in the care management condition. Discussion Our initial findings support the notion that CREST may be able to improve task switching, an important component of executive functioning, in older adults with HD.

scholarly journals Mindfulness-based cognitive therapy v. group psychoeducation for people with generalised anxiety disorder: Randomised controlled trial

2016 ◽  
Vol 209 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Samuel Yeung Shan Wong ◽  
Benjamin Hon Kei Yip ◽  
Winnie Wing Sze Mak ◽  
Stewart Mercer ◽  
Eliza Yee Lai Cheung ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Usual Care ◽  
Cognitive Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Generalised Anxiety Disorder ◽  
Significant Group ◽  
Time Interaction ◽  
Group Time ◽  
Randomised Controlled

BackgroundResearch suggests that an 8-week mindfulness-based cognitive therapy (MBCT) course may be effective for generalised anxiety disorder (GAD).AimsTo compare changes in anxiety levels among participants with GAD randomly assigned to MBCT, cognitive–behavioural therapy-based psychoeducation and usual care.MethodIn total, 182 participants with GAD were recruited (trial registration number: CUHK_CCT00267) and assigned to the three groups and followed for 5 months after baseline assessment with the two intervention groups followed for an additional 6 months. Primary outcomes were anxiety and worry levels.ResultsLinear mixed models demonstrated significant group × time interaction (F(4,148) = 5.10, P = 0.001) effects for decreased anxiety for both the intervention groups relative to usual care. Significant group × time interaction effects were observed for worry and depressive symptoms and mental health-related quality of life for the psychoeducation group only.ConclusionsThese results suggest that both of the interventions appear to be superior to usual care for the reduction of anxiety symptoms.

Differential Experimental Effects of a Short Bout of Walking, Meditation, or Combination of Walking and Meditation on State Anxiety Among Young Adults

2017 ◽  
Vol 32 (4) ◽  
pp. 949-958 ◽  
Author(s):  
Meghan K. Edwards ◽  
Simon Rosenbaum ◽  
Paul D. Loprinzi
Keyword(s):  
Young Adults ◽  
Aerobic Exercise ◽  
State Anxiety ◽  
Controlled Trial ◽  
Significant Group ◽  
Time Interaction ◽  
P 75 ◽  
Short Bout ◽  
Before And After ◽  
Post Hoc

Introduction: Single bouts of aerobic exercise and meditation have been shown to improve anxiety states. Yet to be evaluated in the literature, we sought to examine the effects of a single, short bout of aerobic exercise or meditation, as well as exercise and meditation combined on state anxiety among young adults. Design: Randomized controlled trial. Setting: University. Subjects: Participants (N = 110, mean age = 21.4 years) were randomly assigned to walk, meditate, walk then meditate, meditate then walk, or to sit (inactive control). Measures: All walking and meditation bouts were 10 minutes in duration. Participants’ state anxiety was monitored before and after the intervention using the State Trait Anxiety Inventory questionnaire. Results: Significant group × time interaction effects were observed ( P = .01). Post hoc paired t tests revealed that state anxiety significantly decreased from baseline to postintervention in the meditation ( P = .002), meditation then walk ( P = .002), and walk then meditation ( P = .03) groups but not the walk ( P = .75) or control ( P = .45) groups. Conclusion: Meditation (vs a brisk walk) may be a preferred method of attenuating anxiety symptomology. Individuals desiring the health benefits associated with aerobic exercise may achieve additional anxiolytic benefits if they employ a brief meditation session before or after exercising.

Sign in / Sign up

Export Citation Format

Share Document