Clinical study on repetitive transcranial magnetic stimulation for the improvement of sleep quality in patients with depression

Abstract

Background The prevalence of depressive disorder is increasing. Patients with depression often go to general hospital with chief complaint about somatization symptoms, including sleep disorders as one of the most common chief complaints. Therefore, improvement of sleep quality becomes the most important problem. The aim of this study is to explore the effect of repetitive transcranial magnetic stimulation (rTMS) on the improvement of sleep quality in patients with depression. Methods Forty-two depressive patients were admitted to neurology department of general hospital with somatization symptoms. Patients with Hamilton Depression Rating Scale (HAMD) score ≥ 7 and Hamilton Anxiety Rating Scale (HAMA) score > 14 points were randomly divided into two groups, durg treatment group (given drug only) and combined group (given drug plus rTMS treatment). HAMD total score, HAMA score, sleep disorder, depression, and somatization symptoms were assessed before treatment and 1, 2, 4, and 8 weeks after treatment, respectively, and were compared between two groups. Results The scores in every item were significantly different in both groups at different observation time points (P = 0.000). There were interactions of treatment methods with observation time points (P = 0.000, for all). Compared with drug treatment group, total score of HAMD, score of HAMA and somatization symptoms at 1, 2 and 4 weeks after treatment were decreased (P = 0.000, for all); the score of sleep disorders was decreased at 1 week after treatment (P = 0.001); and the scores of depression at 1 and 2 weeks after treatment were decreased (P = 0.000, for all) in combined group. In comparison with pre-treatment, the differences of scores in every item were significant at different observation time points (P = 0.000), excepting 1 week after treatment in drug treatment group (P > 0.05), but were all significant in combined group (P = 0.000). The total effective rates at 1, 2 and 4 weeks after treatment in combined group [63.64%(14/22), 86.36% (19/22) and 90.91% (20/22)] were all significantly higher than those in drug treatment goup [20% (4/20), 55% (11/20), and 75% (15/20)] (P = 0.000, for all). Conclusion Repetitive transcranial magnetic stimulation combined with drug treatment for patients with depression is better than simple drug therapy in early initiation of efficacy, achievemet of good effect, and improvement of sleep quality, and can raise the compliance with treatment.