Cognitive Remediation in Patients With Bipolar Disorder: A Randomized Trial by Sequential tDCS and Navigated rTMS Targeting the Primary Visual Cortex

作者：Hetong Zhou, Minmin Wang, Ting Xu, Xiaomei Zhang, Xudong Zhao, Lili Tang, Pengfei Zhao, Dandan Wang, Jianbo Lai, Fei Wang, Shaomin Zhang, Shaohua Hu · 发表于：CNS Neuroscience & Therapeutics · 年份：2024 · DOI：10.1111/cns.70179 · 被引用次数：13 · 研究领域：Transcranial Magnetic Stimulation Studies、Electroconvulsive Therapy Studies、Bipolar Disorder and Treatment

BACKGROUND: Non-invasive brain stimulation (NIBS), such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), has emerged as a promising alternative in the precise treatment of clinical symptoms, such as the cognitive impairment of bipolar disorder (BD). Optimizing the neurocognitive effects by combining tDCS and rTMS to strengthen the clinical outcome is a challenging research issue. OBJECTIVE: In this randomized, controlled trial, we first combined tDCS and neuronavigated rTMS targeting the V1 region to explore the efficacy on neurocognitive function in BD patients with depressive episodes. METHODS: Eligible individuals (n = 105) were assigned into three groups, Group A (active tDCS-active rTMS), Group B (sham tDCS-active rTMS), and Group C (active tDCS-sham rTMS). All participants received 3-week treatment in which every participant received 15 sessions of stimulation through the study, 5 sessions every week, with tDCS treatment followed by neuronavigated rTMS every session. We evaluated the cognitive, emotional, and safety outcomes at week-0 (w0, baseline), week-3 (w3, immediately post-treatment), and week-8 (w8, follow-up period). The THINC-integrated tool (THINC-it), 17-item Hamilton Depression Rating Scale, and Young Mania Rating Scale were applied for evaluating the cognitive function and emotional state, respectively. Data were analyzed by repeated measure ANOVA and paired t-test. RESULTS: Eventually, 32 patients i...