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KMID : 0191120200350260205
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Journal of Korean Medical Science
2020 Volume.35 No. 26 p.205 ~ p.205
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Effects of Repetitive Transcranial Magnetic Stimulation on Improvement of Mental Health and Clinical Parameters in Depressed Hemodialysis Patients: a Pilot Study
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Hwang Jin-Ho
Hwang Hyun-Chan
Kim Hye-Ri
Hong Ji-Sun
Han Doug-Hyun
Shin Jung-Ho
Kim Su-Hyun
Kim Sun-Mi
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Abstract
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Background: This study aimed to evaluate the therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) as a nonpharmacologic treatment in depressed hemodialysis patients.
Methods: Patients who scored ≥ 5 on the Patient Health Questionnaire-9 were randomized to either the rTMS (n = 7) or sham group (n = 7). The rTMS group was stimulated with a 110% motor threshold and 10 Hz on the left dorsolateral prefrontal cortex for 20 minutes, three times a week, for 4 weeks. In the sham group, the “1-wing 90-degree method” was used. We analyzed clinical indices before and after the intervention, as well as data from quantitative electroencephalography (frontal alpha asymmetry [FAA]), and various psychiatric questionnaires (Beck Depression Inventory-II, Beck Anxiety Inventory [BAI], Symptom Checklist-90-Revised Somatization Subscale [SCL-90R-SOM]), and Perceived Stress Scale.
Results: One month after rTMS, the changes in hemoglobin A1c levels in the rTMS group were significantly greater than those in the sham group (F = 6.687, P = 0.032). The changes in BAI scores in the rTMS group were significantly greater than those in the sham group (F = 6.700, P = 0.025), and the changes in SCL-90R-SOM scores in the rTMS group were greater than those in the sham group (F = 4.943, P = 0.048). In addition, the changes in the FAA value at the F7 and F8 electrodes in the rTMS group were greater than those in the sham group (F = 6.468, P = 0.027).
Conclusion: In depressed hemodialysis patients, rTMS may improve anxiety and somatization symptoms, which may lead to improvements in clinical measures.
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KEYWORD
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Depression, Kidney, Hemodialysis, Transcranial Magnetic Stimulation, Quantitative Electroencephalogram
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