Comparison of the clinical efficacy of intensive intermittent theta burst stimulation versus high-frequency repetitive transcranial magnetic stimulation therapy in patients with first-episode depression DU Bin 1） , CAO Yin 2） , DONG Guanzhong 2） , ZHANG Qiaoyang 2） , CHEN Zhuoyou 2） 1）Graduate School of Dalian Medical University, Dalian 116044, China 2）Changzhou Second People’s Hospital Affiliated to Nanjing Medical University, Nanjing 213003, China Corresponding author：CAO Yin 【Abstract】 Objective To compare the clinical efficacy of intensive intermittent theta burst stimulation （iTBS）and high frequency（10 Hz）repetitive transcranial magnetic stimulation （rTMS）therapy in patients with first-episode depression. Methods Totally 62 with first-episode depression were randomly received intensive iTBS （n=31, twice-daily iTBS treatments）or 10 Hz rTMS（n=30, once-daily 10 Hz rTMS treatments）. All the patients were treated for 2 weeks and followed up for 2 weeks after treatment. Sertraline（50 mg/d） was used in all patients. Before treatment, at the end of the 1st, 2nd week of treatment and at the end of the 2nd week of the follow up after treatment, the 24-item Hamilton depression rating scale （HAMD-24） was used to assess the severity of clinical symptoms and reduction rates. The degree of anxiety and cognitive function were recorded. We assessed patients with Hamilton anxiety scale（HAMA）, Stroop color and word test（SCWT）, repeatable battery for neuropsychological status（RBANS） before treatment and at 2nd week of treatment. Results There were no between groups differences in reduction rates of HAMD-24 scores at the end of the 1st, 2nd week of treatment and at the end of the 2th week of the follow up after treatment（P>0.05）. At 2nd week of treatment and at the end of the 2th week of the follow up after treatment, there was no statistically significant in response and remission rates in two groups（P>0.05）. Compared with before treatment, HAMD-24 scores in two groups were significantly improved at the end of the 1st, 2nd week of treatment and at the end of the 2th week of the follow up after treatment（P<0.001）. For HAMD-24 scores, there was no statistically significant between two groups during the entire observation period. Compared with before treatment, HAMA scores, total scores of RBANS, immediate memory scores, visual span scores, and delayed memory scores were significantly improved in two groups at 2nd week of treatment（P<0.05）. There was no significant difference between groups at 2nd week of treatment（P<0.05）. Compared with the patients in 10 Hz rTMS group, the patients in intensive iTBS group showed a less the Stroop card C time, Stroop card C-B time and Stroop card C time/correct number at 2nd week of treatment（P<0.05）. Conclusion Intensively applied iTBS appears to have similar efficacy to 10 Hz rTMS in patients with first-episode depression. The improvement of depressive symptoms and anxiety symptoms were found in two groups. We found improvements in cognitive function in two groups, the intensive iTBS group improves executive function significantly better than 10 Hz rTMS. 【Key words】 High-frequency repeated transcranial magnetic stimulation；Depression； Theta burst stimulation；Prefrontal cortex；Executive function
