مقایسه‌ی اثربخشی ویتامین دی، توانبخشی شناختی، تحریک جریان متناوب مغز و ترکیب درمان توانبخشی شناختی و تحریک جریان متناوب مغز بر افسردگی سالمندان مبتلا به نقص شناختی خفیف

نوع مقاله : Original Article(s)

نویسندگان

1 دانشجوی دکتری روانشناسی، گروه روانشناسی، دانشکده‌ی ادبیات و علوم انسانی، دانشگاه لرستان، لرستان، ایران

2 دانشیار، گروه روانشناسی، دانشکده‌ی ادبیات و علوم انسانی، دانشگاه لرستان، لرستان، ایران

3 استاد، گروه روانشناسی، دانشکده‌ی ادبیات و علوم انسانی، دانشگاه لرستان، لرستان، ایران

4 دانشیار، گروه پزشکی داخلی، بیمارستان آیت الله طالقانی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

چکیده

مقاله پژوهشی




مقدمه: افسردگی، پیش‌بینی‌کننده‌ی نقص شناختی در افراد سالمند می‌باشد. هدف پژوهش حاضر، بررسی و مقایسه‌ی اثربخشی ویتامین D، توانمندسازی شناختی (Cognitive rehabilitation therapy) CRT، تحریک فراجمجمه‌ای مغز (transcranial alternating current stimulation) tACS و ترکیب دو درمان (CRT+tACS) بر کاهش افسردگی سالمندان مبتلا به نقص شناختی خفیف بود.
روش‌ها: پژوهش حاضر یک مطالعه‌ی کارآزمایی بالینی نیمه تجربی است که 32 فرد دارای نقص شناختی خفیف بعد از تکمیل تست افسردگی Beck
(Beck Depression Inventory) BDI و (Montreal Cognitive Assessment) MoCA در چهار گروه درمانی بصورت تصادفی اختصاص داده شدند. مداخله‌ی CRT، tACS و CRT+tACS هر کدام ۱۲ جلسه و هفته‌ای دوبار برگزار گردید. هر جلسه CRT و tACS۲۰ دقیقه و هر جلسه درمان توانبخشی شناختی بعلاوه tACS به مدت ۴۰ دقیقه اجرا گردید و در گروه دریافت ویتامین D به مدت ۶ هفته روزانه ۲۰ میکروگرم معادل با ۸۰۰ IU ویتامین D دریافت کردند. قبل از انجام پژوهش تست افسردگی Beck (BDI) و تست MoCA و در پایان پژوهش BDI گرفته شد تا اثربخشی درمان‌ها بر کاهش افسردگی بررسی شود. به منظور تحلیل نتایج از آزمون آماری اندازه‌گیری مکرر با سطح معنی‌داری کمتر از 0/05 مختلط استفاده شد.
یافته‌ها: بر اساس نتایج بدست آمده در گروه‌CRT  شاهد کاهش معنی‌دار نمرات افسردگی بک از ۱۱ به ۹ بودیم. در گروه ACS، CRT+tACS و ویتامین D تفاوت بین نمرات افسردگی معنی‌دار نبود.
نتیجه‌گیری: بر اساس مطالعه‌ی حاضر، CRT باعث کاهش نمره‌ی افسردگی در بین افراد دارای نقص شناختی خفیف می‌شود و این درمان در مقایسه با tACS، CRT+tACS و ویتامین D مؤثرتر بود.

تازه های تحقیق

فریبا ابراهیم بابایی: Google Scholar

کورش امرایی: Google Scholar, PubMed

فیروزه غضنفری: Google Scholar, PubMed

پریسا طاهری تنجانی: Google Scholar, PubMed

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Comparison of the Effectiveness of Vitamin D, Integrated Cognitive Rehabilitation Therapy, Transcranial Alternating Current Stimulation on Depression in Patients with Mild Cognitive Impairment

نویسندگان [English]

  • Fariba Ebrahimbabaie 1
  • Kourosh Amraei 2
  • Firoozeh Ghazanfari 3
  • Parisa Taheri Tanjani 4
1 PhD Student, Department of Psychology, School of Literature and Humanities’Sciences, Lorestan University, Lorestan, Iran
2 Associate Professor, Department of Psychology, School of Literature and Humanities’Sciences, Lorestan University, Lorestan, Iran
3 Professor, Department of Psychology, School of Literature and Humanities’Sciences, Lorestan University, Lorestan, Iran
4 Associate Professor, Department of Internal Medicine, Ayatollah Taleghani Hospital, Research Development Unit, Shahid Beheshti University of Medical Sciences, Tehran, Iran
چکیده [English]

Background: Depression is a predictor of cognitive impairment in aged people. This study aimed to compare the effect of Vitamin D, integrated cognitive rehabilitation therapy (CRT), transcranial alternating current stimulation (tACS), and a combination of CRT and tACS on depression in patients with mild cognitive impairment (MCI).
Methods: The present study is a semi-experimental clinical trial study in which 32 people with mild cognitive impairment were randomly assigned to four treatment groups after completing the Beck Depression Test and the Mocha Test. CRT, tACS, and CRT + tACS interventions were held twice a week for 12 sessions each. Each session of CRT and tACS lasted 20 minutes, and each session of cognitive rehabilitation treatment plus TACS was performed for 40 minutes, and the group receiving vitamin D; received 20 micrograms equivalent to 800 IU of vitamin D daily for six weeks. Before conducting the research, the Beck depression test (BDI) and MoCA test were taken, and at the end of the research, BDI was taken to check the effectiveness of treatments on reducing depression. To analyze the results, the repeated measurement statistical test with a significance level of less than 0.05 was used.
Findings: The results showed that the depression scores decreased significantly in the cognitive rehabilitation intervention group from 11 to 9. However, no significant difference was observed in the transcranial alternating current stimulation (tACS) and combination of CRT and tACS and vitamin D groups.
Conclusion: According to the present study, CRT decreased depression scores in MCI, and it is more effective in reducing depression compared to tACS, CRT+tACS, and vitamin D.

کلیدواژه‌ها [English]

  • Cognitive Dysfunction
  • Impairment
  • Vitamin D
  • Cognitive training
  • Transcranial alternating current stimulation
  • Depression

مراجع

  1. Lu Y, Liu C, Yu D, Fawkes S, Ma J, Zhang M, et al. Prevalence of mild cognitive impairment in community-dwelling Chinese populations aged over 55 years: a meta-analysis and systematic review. BMC Geriatr 2021; 21(1): 10.
  2. Ma L. Depression, anxiety, and apathy in mild cognitive impairment: current perspectives. Front Aging Neurosci 2020; 12: 9.
  3. Ismail Z, Elbayoumi H, Fischer CE, Hogan DB, Millikin CP, Schweizer T, et al. Prevalence of depression in patients with mild cognitive impairment: a systematic review and meta-analysis. JAMA Psychiatry 2017; 74(1): 58-67.
  4. Rodakowski J, Saghafi E, Butters MA, Skidmore ER. Non-pharmacological interventions for adults with mild cognitive impairment and early stage dementia: An updated scoping review. Mol Aspects Med 2015; 43: 38-53.
  5. Chae HJ, Lee SH. Effectiveness of online-based cognitive intervention in community-dwelling older adults with cognitive dysfunction: A systematic review and meta-analysis. Int J Geriatr Psychiatry 2023; 38(1): e5853.
  6. Alexander ML, Alagapan S, Lugo CE, Mellin JM, Lustenberger C, Rubinow DR, et al. Double-blind, randomized pilot clinical trial targeting alpha oscillations with transcranial alternating current stimulation (tACS) for the treatment of major depressive disorder (MDD). Transl Psychiatry 2019; 9(1): 106.
  7. Benussi A, Cantoni V, Cotelli MS, Cotelli M, Brattini C, Datta A, et al. Exposure to gamma tACS in Alzheimer’s disease: A randomized, double-blind, sham-controlled, crossover, pilot study. Brain Stimul 2021; 14(3): 531-40.
  8. Haller N, Senner F, Brunoni AR, Padberg F, Palm U. Gamma transcranial alternating current stimulation improves mood and cognition in patients with major depression. J Psychiatr Res 2020; 130: 31-4.
  9. Shekelle PG, Cook IA, Miake-Lye IM, Mak S, Booth MS, Shanman R, et al. The effectiveness and risks of cranial electrical stimulation for the treatment of pain, depression, anxiety, PTSD, and insomnia: A systematic review [Internet].
  10. Ouma S, Suenaga M, Bölükbaşı Hatip FF, Hatip-Al-Khatib I, Tsuboi Y, Matsunaga Y. Serum vitamin D in patients with mild cognitive impairment and Alzheimer's disease. Brain Behav 2018; 8(3): e00936.
  11. Berridge MJ. Vitamin D deficiency accelerates ageing and age-related diseases: a novel hypothesis. J Physiol 2017; 595(22): 6825-36.
  12. Lee CH, Kim DH, Moon YS. Differential associations between depression and cognitive function in MCI and AD: a cross-sectional study. Int Psychogeriatr 2019; 31(8): 1151-8.
  13. Guzek D, Kołota A, Lachowicz K, Skolmowska D, Stachoń M, Głąbska D. Effect of vitamin D supplementation on depression in adults: A systematic review of randomized controlled trials (RCTs). Nutrients 2023; 15(4): 951.
  14. Hansen JP, Pareek M, Hvolby A, Schmedes A, Toft T, Dahl E, et al. Vitamin D3 supplementation and treatment outcomes in patients with depression (D3-vit-dep). BMC Res Notes 2019; 12(1): 203.
  15. Zhu C, Zhang Y, Wang T, Lin Y, Yu J, Xia Q, et al. Vitamin D supplementation improves anxiety but not depression symptoms in patients with vitamin D deficiency. Brain Behav 2020; 10(11): e01760.
  16. Hopkins J, Hill K, Jacques A, Burton E. Prevalence, risk factors and effectiveness of falls prevention interventions for adults living with Mild Cognitive Impairment in the community: A systematic review and meta-analysis. Clin Rehabil 2023; 37(2): 215-43.
  17. Motter JN, Pimontel MA, Rindskopf D, Devanand DP, Doraiswamy PM, Sneed JR. Computerized cognitive training and functional recovery in major depressive disorder: a meta-analysis. J Affect Disord 2016; 189: 184-91.
  18. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53(4): 695-9.
  19. Beck AT, Steer RA, Ball R, Ranieri WF. Comparison of beck depression inventories-IA and-II in psychiatric outpatients. J Pers Assess 1996; 67(3): 588-97.
  20. Abedini S, Davachi A, Sohbaee F, Mahmoodi M,
    Safa O. Depression in medical and nursing students, Bandar Abbas [in Persian]. Hormozgan Med J 2007; 11(2): 144-50.
  21. Hill NT, Mowszowski L, Naismith SL, Chadwick VL, Valenzuela M, Lampit A. Computerized cognitive training in older adults with mild cognitive impairment or dementia: a systematic review and meta-analysis. Am J Psychiatry 2017; 174(4): 329-40.
  22. Bahar-Fuchs A, Martyr A, Goh AM, Sabates J, Clare L. Cognitive training for people with mild to moderate dementia. Cochrane Database Syst Rev 2019; 3(3): CD013069.
  23. Giustiniani A, Maistrello L, Danesin L, Rigon E, Burgio F. Correction to: Effects of cognitive rehabilitation in Parkinson disease: a metaanalysis. Neurol Sci 2022; 43(4): 2917.
  24. Bahar-Fuchs A, Clare L, Woods B. Cognitive training and cognitive rehabilitation for persons with mild to moderate dementia of the Alzheimer's or vascular type: a review. Alzheimers Res Ther 2013; 5(4): 35.
  25. Suemoto CK, Apolinario D, Nakamura-Palacios EM,
    Lopes L, Leite RE, Sales MC, et al. Effects of a non-focal plasticity protocol on apathy in moderate Alzheimer's disease: a randomized, double-blind, sham-controlled trial. Brain Stimul 2014; 7(2):
    308-13.
  26. Brunoni AR, Tortella G, Benseñor IM, Lotufo PA, Carvalho AF, Fregni F. Cognitive effects of transcranial direct current stimulation in depression: results from the SELECT-TDCS trial and insights for further clinical trials. J Affect Disord 2016; 202: 46-52.
  27. Kehler L, Francisco CO, Uehara MA, Moussavi Z. The effect of transcranial alternating current stimulation (tACS) on cognitive function in older adults with dementia. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020: 3649-53.
  28. van De Rest O, van der Zwaluw NL, Tieland M, Adam JJ, Hiddink GJ, Van Loon LJ, et al. Effect of resistance-type exercise training with or without protein supplementation on cognitive functioning in frail and pre-frail elderly: secondary analysis of a randomized, double-blind, placebo-controlled trial. Mech Ageing Dev 2014; 136-137: 85-93.
مجله دانشکده پزشکی اصفهان
دوره 42، شماره 755
هفته 3، فروردین
فروردین و اردیبهشت 1403
صفحه 58-68

فایل ها

سابقه مقاله

  • تاریخ دریافت: 28 مرداد 1402
  • تاریخ بازنگری: 14 بهمن 1402
  • تاریخ پذیرش: 14 بهمن 1402

هم رسانی

ارجاع به این مقاله

آمار