The long-term effect of repetitive transcranial magnetic stimulation in the treatment of intractable insomnia

Hongwei Wu; Jin Lv; Minfen Liu; Yu Wu; Yanzhou Qu; Liqun Ji; Likang Lan

doi:10.1016/j.sleep.2021.07.018

The long-term effect of repetitive transcranial magnetic stimulation in the treatment of intractable insomnia

Sleep Med. 2021 Sep:85:309-312. doi: 10.1016/j.sleep.2021.07.018. Epub 2021 Jul 20.

Authors

Hongwei Wu¹, Jin Lv¹, Minfen Liu¹, Yu Wu¹, Yanzhou Qu¹, Liqun Ji¹, Likang Lan²

Affiliations

¹ Department of Neurology, The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China.
² Department of Neurology, The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China. Electronic address: lsllk67@163.com.

PMID: 34391006
DOI: 10.1016/j.sleep.2021.07.018

Abstract

Objective: To explore the differences in clinical efficacy of different courses of repetitive transcranial magnetic stimulation (rTMS) in the treatment of intractable insomnia and the duration of clinical efficacy after cessation of treatment.

Method: 70 patients with intractable insomnia were randomly divided into 1 treatment course group and 2 treatment courses group. The rTMS course consisted of daily sessions of 1200 stimuli for the r-DLPFC at a frequency of 1 Hz and 800 stimuli for parietal lobe (CPZ) at a frequency of 1 Hz. The pitchburg sleep index (PSQI), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and cardiopulmonary coupled sleep (CPC) were assessed for 35 patients in each group at baseline, at 2 weeks, and at 1 and 3 months after treatment.

Result: The scores of PSQI, HAMD and HAMA in the 2 groups were significantly improved after 1 month of follow-up after rTMS treatment (p < 0.01). The long-term effect of different treatment courses is different. After 2 consecutive courses of treatment, there was still a significant difference between the 3-month follow-up and the pre-treatment period (p < 0.05). However, there was no statistical difference between the 3-month follow-up of one course of treatment and the pre-treatment period. The results of CPC test showed that the improvement of total sleep time (TST), and deep sleep time (DST) was basically consistent with the assessment of PSQI, HAMD and HAMA that the clinical efficacy of the 3-month follow-up was better than that of one course of treatment after 2 consecutive courses of treatment.

Conclusion: The treatment of refractory insomnia by rTMS is effective, and the duration of the curative effect is related to the course of treatment. 2 consecutive courses of treatment still have a certain effect after 3 months, which is worthy of clinical promotion.

Keywords: Intractable insomnia; The long-term effect; Transcranial magnetic stimulation.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Humans
Sleep
Sleep Initiation and Maintenance Disorders* / therapy
Transcranial Magnetic Stimulation*
Treatment Outcome