RESUMEN
BACKGROUND: Major depressive disorder (MDD) is a significant cause of workforce loss, and is associated with cognitive impairments which can continue even after the elimination of mood and behavioural symptoms. The aim of this study was to investigate the benefit of transcranial magnetic stimulation (TMS) on cognitive functions in treatment resistant depression. METHODS: This randomised controlled clinical trial was conducted at a university hospital, department of psychiatry (tertiary centre) between October 2019 and July 2020. The study included 30 patients with depressive disorder, aged 18-50 years, who did not respond to at least two antidepressant medications for at least 8 weeks (one drug used was serotonin norepinephrine reuptake inhibitor [SNRI]; and 15 healthy control subjects. The patients were separated into two equal groups in a double-blind, random manner, and 20 sessions of repeated TMS was applied to one group, and 20 sessions of sham TMS to the other. The Montgomery Asberg Depression Scale (MADRS), Hamilton Depression Rating Scale (HAM-D), Stroop test, Wisconsin Card Sorting Test (WCST), Digit Span Test (DST), Trail Making Test A-B, and Verbal Memory Processes Test (VMPT) were applied to the patients before and after the TMS procedure. RESULTS: The decrease in the HAM-D score was greater in the active magnetic stimulation (25 trains, 10 Hz, 110% motor threshold intensity) group, and with the exception of verbal memory processes, better performance was obtained by the active magnetic stimulation group than the sham group in the cognitive function tests. DISCUSSION: TMS was seen toimprove the cognitive defects present in the active phase of treatment-resistant depression, and therefore TMS could provide early improvement in cognitive functions in clinical use. Key words: Depression, transcranial magnetic stimulation, neurocognitive functi.
Asunto(s)
Trastorno Depresivo Mayor , Trastorno Depresivo Resistente al Tratamiento , Humanos , Estimulación Magnética Transcraneal/métodos , Trastorno Depresivo Mayor/terapia , Trastorno Depresivo Resistente al Tratamiento/terapia , Trastorno Depresivo Resistente al Tratamiento/psicología , Depresión , Escalas de Valoración Psiquiátrica , Resultado del Tratamiento , Método Doble Ciego , CogniciónRESUMEN
OBJECTIVE: The aim of this study was to determine whether or not patients with obsessive compulsive disorder (OCD) differed from the control group in paying spontaneous attention to gaze cueing. METHOD: The OCD patient and control groups were tested on a shortened version of Social Distance Judgement Task using pictures of two human cartoon figures with their bodies directed toward the observer and their heads facing each other or in opposite directions. Participants were asked to compare the distances between the cartoon figures and between the blocks drawn under each figure, while their eye movements were recorded by eye-tracking equipment. Before the recording, a rectangular area, with its lower side located at the shoulder region of the cartoon figures, was determined as the area of interest for visual fixation. During the test, human cartoon figures were presented on a computer screen, and the number and duration of visual fixations on the area of interest by both patients and controls were recorded and compared with each other. RESULTS: In comparison to the control group, the patients with OCD had less number (p=0.029) and duration (p=0.051) of visual fixations on the head and surrounding region of the cartoon figures. The number and duration of fixations on the region of interest did not show correlation with the severity of symptoms. CONCLUSION: Patients with OCD are less likely to pay spontaneous attention to gaze cueing in comparison to healthy individuals. Impairment in spontaneous attention to social cues may underlie the social functioning disorders observed in these patients.