Repetitive transcranial magnetic stimulation promotes response inhibition in patients with major depression during the stop-signal task.

BACKGROUND: Response inhibition (RI) deficit is an aspect of cognitive impairment in depressed individuals, but currently no effective treatment has been established. This study aimed to explore the effect of individualized repetitive transcranial magnetic stimulation (rTMS) targeting the left dorsolateral prefrontal cortex (lDLPFC)-nucleus accumbens (NAcc) network on RI in patients with major depressive disorder (MDD). METHODS: Fourty-four patients diagnosed with MDD were randomized to receive 15 once-daily sessions of active (10 Hz, 100% of resting motor threshold) or sham rTMS within a double-blind, sham-controlled trial. We measured the efficacy of rTMS by the improvements in behavioral and neurological manifestations during the stop-signal task. The Hamilton Depression Rating Scale-17 items (HAMD-17) was used to assess depressive symptoms. We analyzed the differences in RI performance between MDD patients and 30 healthy controls (HCs) at baseline and assessed whether MDD patients who completed rTMS treatment had comparable RI ability to HCs. RESULTS: At baseline, the depressed patients showed longer stop-signal response time (SSRT), smaller P3 amplitudes, and weaker theta-band power in successful stop trials (SSTs) than HCs. The active group exhibited RI ability comparable to that of HCs after rTMS treatment, but the improvements were not significant in the sham group. The active group showed significant remission in depression symptoms post-treatment compared to the sham group, and the changes in P3 amplitudes and theta-band power during SSTs were negatively correlated with the decrease of HAMD-17 scores. CONCLUSION: The depressed patients have impaired RI and treatment with the individualized rTMS protocol may be an effective approach.

The Relationship Between Suicidal Ideation and Parental Attachment Among Adolescents: The Mediator of Anhedonia and Peer Attachment.

Background: Previous studies had shown that poor quality of early parental attachment is a risk factor for suicide, but few have focus on the mechanism between suicidal ideation and parental attachment. The aim of this study was to explore how parental attachment, anhedonia, and peer attachment were associated with suicidal ideation in adolescents. Method: Participants were enrolled in middle schools, in Hefei, Anhui, China. All participants completed socio-demographic characteristic and standard assessments on parental attachment, peer attachment, anhedonia, and suicidal ideation by paper surveys. The effect of parental attachment on suicidal ideation mediated by anhedonia and peer attachment was analyzed by a structural equation model (SEM) using SPSS AMOS 23.0. Results: The SEM analysis revealed that the standard total effect of parental attachment on suicidal ideation was -0.137 (Z=-27.00, 95% confidence interval [CI; -0.147, -0.127], p<0.001), with a direct effect of parental attachment on suicidal ideation of -0.107 (Z=-21.40, 95% CI [-0.117, -0.098], p<0.001), while the indirect effects were-0.002 (Z=-3.33, 95% CI [-0.003, -0.002], p<0.001) in the pathway of parental attachment-anhedonia-peer attachment-suicidal ideation, -0.019 (Z=-19.00, 95%CI [-0.022, -0.017], p<0.001) in the pathway of parental attachment-anhedonia-suicidal ideation, and-0.008 (Z=-7.00, 95% CI [-0.010, -0.007], p<0.001) in the pathway of parental attachment-peer attachment-suicidal ideation. Conclusion: The study suggested that parental attachment could directly influence suicidal ideation and indirectly influence suicidal ideation via anhedonia and peer attachment. The results emphasized the importance of attachment in infancy and verified the feasibility of intervention on anhedonia and peer attachment to prevent suicidal ideation.