Collins AR, Cheung J, Croarkin PE, Kolla BP, Kung S. Effects of transcranial magnetic stimulation on sleep quality and mood in patients with major depressive disorder.
J Clin Sleep Med 2021;
18:1297-1305. [PMID:
34931606 PMCID:
PMC9059593 DOI:
10.5664/jcsm.9846]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES
It is unknown whether sleep quality improvements after repetitive transcranial magnetic stimulation (rTMS) are inherent to the intervention or related to improvements in depressive symptoms. This retrospective study examined sleep quality in patients with major depressive disorder (MDD) before and after treatment with rTMS, adjusting for age, sex, sedative-hypnotic use, number of rTMS treatments, depression severity and changes in depressive symptoms.
METHODS
Adults with MDD underwent a six-week course of 10 Hz rTMS over the left dorsolateral prefrontal cortex (DLPFC). Patients completed the Patient Health Questionnaire-9 (PHQ-9) depression rating scale and Pittsburgh Sleep Quality Index (PSQI) before and after treatment. To limit confounding, analysis of depressive symptoms occurred without item 3 (the sleep item) of the PHQ-9.
RESULTS
Twenty-one patients completed the study, with a mean (± standard deviation) baseline PSQI score of 12.0 (±3.8), compared to 10.5 (±4.3) post-treatment (p = 0.01). The mean baseline PHQ-9 score without item 3 was 17.3 (±3.0), compared to 12.2 (±4.9) post-treatment (p = 0.0001). PSQI and modified PHQ-9 changes were uncorrelated in non-adjusted and adjusted linear regression models, as well as in Spearman's rank-order correlation.
CONCLUSIONS
Mood and sleep quality improved independently following rTMS treatment, even after adjusting for age, sex, sedative-hypnotic use, number of rTMS treatments and depression severity. These findings suggest that rTMS exerts direct effects on both mood and sleep in patients with MDD.
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