Kaptsan Alex, Yaroslavsky Yuri, Applebaum Julia, Belmaker R H, Grisaru Nimrod
Faculty of Health Sciences, Stanley Research Center, Ministry of Health Mental Health Center, Ben Gurion University of the Negev, Beer-Sheba, Israel.
Bipolar Disord. 2003 Feb;5(1):36-9. doi: 10.1034/j.1399-5618.2003.00003.x.
Left prefrontal transcranial magnetic stimulation (TMS) has been reported to have ECT-like effects in depression and we therefore planned a study of TMS in mania. Sixteen patients completed trial of right versus left prefrontal TMS at 20 Hz, 2-sec duration per train, 20 trains per day for 10 treatment days. Mania was evaluated using the Mania Scale, the Brief Psychiatric Rating Scale and the Clinical Global Impression. Significantly more improvement was observed in patients treated with right prefrontal TMS than with left prefrontal. We now report a follow-up study of right active TMS versus right sham TMS with the same indications and parameters.
Twenty-five patients entered and 19 completed right TMS versus sham right TMS.
Right TMS was no more effective than sham TMS.
It is possible that the previous results were due to an effect of left TMS to worsen mania. Alternatively, it is noted that the present patient group had much more psychosis than the previous study of TMS in mania, and depression studies have reported that psychosis is a poor prognostic sign for TMS response.
据报道，左侧前额叶经颅磁刺激（TMS）在抑郁症中具有类似电休克治疗（ECT）的效果，因此我们计划开展一项针对躁狂症的TMS研究。16名患者完成了一项试验，比较右侧与左侧前额叶TMS，频率为20Hz，每次脉冲持续2秒，每天20次脉冲，共治疗10天。使用躁狂量表、简明精神病评定量表和临床总体印象量表对躁狂症进行评估。结果发现，接受右侧前额叶TMS治疗的患者比接受左侧前额叶TMS治疗的患者改善更为显著。我们现在报告一项针对具有相同适应症和参数的右侧主动TMS与右侧假TMS的随访研究。
25名患者参与研究，19名完成了右侧TMS与右侧假TMS的对比。
右侧TMS并不比假TMS更有效。
先前的结果可能是由于左侧TMS有使躁狂症恶化的作用。另外，需要注意的是，与先前关于TMS治疗躁狂症的研究相比，本患者组存在更多的精神病症状，并且抑郁症研究报告称，精神病症状是TMS治疗反应的不良预后指标。
