講師資料
Talks：
Effects of intermittent theta-burst stimulation on sleep quality in patients with narcolepsy type 1 and type 2 with comorbid depression
iTBS對於共病憂鬱症之第一型與第二型猝睡症患者睡眠品質之影響研究
Name：
金韋志（Wei-Chih Chin）
Position：
主治醫師
Affiliation：
Division of Psychiatry and Sleep Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Email：
Photo：
Research Interests：
Sleep Medicine, Psychiatry
Selected Publications：
1. Chin WC†, Huang SY†, Liu FY., Wang CH, Tang I, Hsiao IT, Huang YS*. The Application of Machine Learning on Brain Imaging Features of Different Narcolepsy Subtypes. Sleep. 2024; 47(2):zsad328. (SCI；IF=4.9；Clinical Neurology 33/285)
2. Chin WC, Huang YS*, Lam NYT, Mak KY, Tang I, Wang CH, Lin C. Effects of Modafinil on Nocturnal Sleep Patterns in Patients with Narcolepsy: A Cohort Study. Sleep Medicine. 2024;119:95-112. (SCI；IF=3.4；Clinical Neurology 78/285)
3. Chin WC†, Chu PH†, Wu LS, Lee KT, Lin C, Ho CT, Yang WS, Chung IH, Huang YS*. The Prognostic Significance of Sleep and Circadian Rhythms on Myocardial Infarction Outcomes: A case-control study. Journal of Medical Internet Research, 2025;27:e63897. (SCI；IF=6.0；Health Care Sciences & Services 12/185)
4. Huang YS., Chin WC*, Chung IH, Roan TY, Chang CJ, Juang HT, Chang SC, Ghosh S, Crawford S, Lin HL. The prevalence, incidence and burden of narcolepsy and idiopathic hypersomnia in Taiwan: comparison between the National Health Insurance Research Claims Database and a hospital cohort database. Sleep. 2025; zsaf132. (SCI；IF=4.9；Clinical Neurology 33/285)
Abstract：
Background: Patients with type 1 (NT1) and type 2 (NT2) narcolepsy often experience comorbid depression that worsens sleep quality. Here, we investigated the impact of left dorsolateral prefrontal cortex (DLPFC) intermittent theta-burst stimulation (iTBS) on sleep quality in NT1 and NT2 patients with comorbid depression, assessed by subjective questionnaires and actigraphy.
Methods: This is an open-label clinical study and a total of fifty-one patients with narcolepsy and comorbid depression were recruited. Intermittent theta burst stimulation (iTBS) was administered over the left dorsolateral prefrontal cortex (DLPFC) at 1,000 pulses/session (9 minutes duration) at 100% RMT in three consecutive session. Clinical assessments were performed at baseline and post-treatment follow-ups by subjective questionnaires and actigraphy monitoring during the follow-up period. Within-group changes were evaluated using the Wilcoxon signed-rank test. Differences between groups were evaluated using the Mann–Whitney U test.
Results: The NT2 group demonstrated significant, sustained reductions in the total Pittsburgh Sleep Quality Index (PSQI) scores across all follow-ups (p = 0.012), driven by improvements in subjective sleep quality, sleep latency, and daytime functioning. The NT1 group showed minimal change in total PSQI scores, yielding a significant between-group difference (p = 0.013). In Depressive Symptoms, NT2 patients showed a substantially higher reduction in the BDI scores compared to NT1 patients (p = 0.001). Both groups showed initial modest improvements in the ESS scores that attenuated over time, with no significant between-group differences during later follow-ups. Most actigraphy parametric variables showed no significant within-group changes across follow-ups.
Conclusion: Left DLPFC iTBS significantly improved subjective sleep quality and depressive symptoms in NT2 patients with comorbid depression, whereas NT1 patients demonstrated minimal response. These findings suggest that therapeutic response to prefrontal neuromodulation can be subtype-dependent, likely reflecting the more severe, uncompensated orexinergic deficit in NT1. Randomized sham-controlled trials are required to confirm these preliminary findings.

Keywords: intermittent theta burst stimulation, narcolepsy, sleeping quality, depression, actigraphy
2026年會：