Effectiveness Evaluation of Repetitive Transcranial Magnetic Stimulation Therapy Combined with Mindfulness-Based Stress Reduction for People with Post-Stroke Depression: A Randomized Controlled Trial.
Haoran Duan, Xin Yan, Shifeng Meng, Lixia Qiu, Jiayu Zhang, Chunxia Yang, Sha Liu
International Journal of Environmental Research and Public Health January 4, 2023 DOI: 10.3390/ijerph20020930 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Double-blind Peer reviewed |
|---|---|
| Sample size | 72 |
| Population | Patients with post-stroke depression recruited from a Rehabilitation Medicine Centre |
| Interventions | mindfulness-based stress reduction (MBSR) general psychological care |
| Duration | 8-week follow-up |
| Measures | 17-item Hamilton Depression Rating Scale (HAMD-17), mini-mental state examination (MMSE), Modified Barthel Index (MBI), Pittsburgh Sleep Quality Index (PSQI) |
| Topics | Depression Meditation |
| Keywords | Cognitive function Mindfulness-based intervention Post-stroke depression Rehabilitation nursing |
| Key findings | Combined rTMS and MBSR produced significantly greater improvements in depression, cognitive function, activities of daily living, and sleep quality compared with sham rTMS plus MBSR or sham rTMS plus general psychological care, with significant time-by-group interactions (p < 0.001). Cognitive function, sleep quality, and daily living abilities were associated with depressive symptoms, and cognitive function was identified as a potential predictor of depression improvement. |
Abstract
Background: Post-stroke depression (PSD) is most prevalent during the rehabilitative period following a stroke. Recent studies verified the effects of repetitive transcranial magnetic stimulation therapy (rTMS) and mindfulness-based stress reduction (MBSR) in patients with depression. However, the effectiveness and prospect of application in PSD patients remain unclear. This study sought to evaluate the effectiveness of a combined intervention based on rTMS and MBSR for the physical and mental state of PSD patients.
Methods: A randomized, double-blind, sham-controlled study design was employed. Participants were recruited from the Rehabilitation Medicine Centre and randomly assigned to receive either MBSR combined with active or sham rTMS or sham rTMS combined with general psychological care. We used a 17-item Hamilton Depression Rating Scale (HAMD-17), a mini-mental state examination (MMSE), the Modified Barthel Index (MBI), and the Pittsburgh Sleep Quality Index (PSQI) to evaluate depressed symptoms, cognitive function, activities of daily living (ADL), and sleep quality at baseline, post-intervention, and the 8-week follow-up. A two-factor analysis of variance was used to compare differences between groups, and Pearson’s linear correlation was used to analyze the possible relationship between variables and potential predictors of depression improvement.
Results: Seventy-two participants were randomized to rTMS−MBSR (n = 24), sham rTMS−MBSR (n = 24), or sham rTMS−general psychological care (n = 24). A total of 71 patients completed the questionnaire, a 99% response rate. There were significant time and group interaction effects in HAMD-17, MMSE, MBI, and PSQI scores (p < 0.001). The repeated-measure ANOVA showed a significant improvement of all variables in rTMS−MBSR compared to sham rTMS−MBSR and sham rTMS combined with general psychological care (p < 0.05). Additional results demonstrated that cognitive function, sleep quality, and activities of daily living are associated with depressive symptoms, and cognitive function is a potential variable for improved depression.
Conclusion: Depressive symptoms can be identified early by assessing cognitive function, and rTMS−MBSR might be considered a potentially helpful treatment for PSD.