Psychiatry and Clinical Psychopharmacology
Original Article

Cognitive Improvements from Adjunct Therapy with Transcranial Magnetic Stimulation are Short-Lived In Patients with Remitted Bipolar Disorder

1.

Tianjin Anding Hospital, Department of Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory

2.

School of Mental Health, Jining Medical University Department of Biological Psychiatry

3.

The Fourth Center Hospital of Tianjin, Department of Radiology

4.

Wenzhou Seventh People’s Hospital, Department of Psychiatry, Wenzhou

5.

Wenzhou Seventh People’s Hospital, Department of Psychiatry and Neuroimaging Centre, Wenzhou, China

Psychiatry and Clinical Psychopharmacology 2020; 30: 346-353
DOI: 10.5455/PCP.20200221124442
Read: 1304 Downloads: 748 Published: 20 January 2021

Background: Repetitive transcranial magnetic stimulation (rTMS) has been used as an adjunct therapy to improve the cognitive abilities of patients with remitted bipolar disorder (BPD). This is accomplished through functional brain activity alterations. However, there is limited information about the duration and persistence of cognitive improvements. In the current study, we investigated the long-term (four weeks) cognitive effects of adjunct treatment with rTMS in patients with remitted BPD.

Methods: wenty-one patients with remitted BDP were enrolled in the study. rTMS was used in patients for four weeks. Global functional connectivity density (gFCD) was used to assess the alterations in brain activity before and after rTMS. The MATRICS Consensus Cognitive Battery (MCCB) was used to evaluate the cognitive abilities of patients before and after rTMS.

Results: Compared to the baseline, cognitive improvements were detected in patients at the end of two weeks of treatment, as determined through increased MCCB scores. Increases in gFCD were observed in the frontal cortex, inferior temporal lobe, and parietal lobe. However, the MCCB scores remained stable during the third week of treatment and began to decline by four weeks post-treatment. Similarly, the increased gFCD values also declined to nearly baseline values by the fourth week posttreatment.

Conclusions: High frequency rTMS can improve the cognitive abilities of patients with remitted BPD rapidly; however, the beneficial effects are short-lived and begin to disappear by three weeks after treatment. The brain activity alterations induced by rTMS also increased initially, followed by substantial declines, suggesting that desensitization or exhaustion may play a role. Further studies are needed to determine the optimal method for maintaining long-term cognitive improvements in patients with remitted BPD.

To cite this article: Wang Y, Liu C, Fang T, Lin X, Jiang D, Zhu J, Zhuo C, Jiaen Ye J. Cognitive Improvements from Adjunct Therapy with Transcranial Magnetic Stimulation are Short-Lived In Patients with Remitted Bipolar Disorder. Psychiatry and Clinical Psychopharmacology 2020;30(4):346-353

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