Anderson Berry, Mishory Alexander, Nahas Ziad, Borckardt Jeffrey J, Yamanaka Kaori, Rastogi Komal, George Mark S
Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, 29425, USA.
J ECT. 2006 Mar;22(1):49-53. doi: 10.1097/00124509-200603000-00011.
Repetitive transcranial magnetic stimulation (rTMS) is an experimental technology that involves a powerful magnetic pulse applied to the scalp, which is sufficient to cause neuronal depolarization. Transcranial magnetic stimulation has been used in treatment studies for psychiatric disorders, primarily unipolar depression, and as a tool to map brain function. Although thousands of rTMS sessions have been given with few side effects, rTMS can produce serious adverse effects such as an unintended seizure. Safety guidelines for frequency, duration, and intensity of rTMS have aided in the prevention of such adverse side effects. However, the total dose (number of stimuli) able to be delivered safely to human subjects within a day or within a week has not been established. For example, previous rTMS studies as a treatment for depression consisted of delivering 800 to 3,000 magnetic pulses per day, with 8000 to 30,000 magnetic pulses over 2 to 3 weeks. This study examined whether high doses of rTMS within a day or over a week would produce significant side effects. As part of a study to examine rTMS effects in sleep deprivation, we exposed healthy men to 12,960 magnetic pulses a day for up to 3 days in 1 week. This equals 38,880 magnetic pulses over 1 week, which is likely one of the largest exposures of TMS to date. Despite this intense treatment regimen, we failed to produce significant side effects. Doses of up to 12,960 pulses per day appear safe and tolerable in healthy young men.
重复经颅磁刺激（rTMS）是一项实验性技术，它涉及向头皮施加强大的磁脉冲，这种磁脉冲足以引起神经元去极化。经颅磁刺激已被用于精神疾病的治疗研究，主要是单相抑郁症，并且作为一种绘制脑功能的工具。尽管已经进行了数千次rTMS治疗，副作用很少，但rTMS仍可能产生严重的不良反应，如意外癫痫发作。rTMS的频率、持续时间和强度的安全指南有助于预防此类不良副作用。然而，一天或一周内能够安全地施加给人类受试者的总剂量（刺激次数）尚未确定。例如，先前作为抑郁症治疗方法的rTMS研究包括每天施加800至3000次磁脉冲，在2至3周内施加8000至30000次磁脉冲。本研究考察了一天内或一周内高剂量的rTMS是否会产生显著的副作用。作为一项研究rTMS对睡眠剥夺影响的一部分，我们让健康男性在1周内连续3天每天接受12960次磁脉冲。这相当于1周内38880次磁脉冲，这可能是迄今为止rTMS最大的暴露量之一。尽管采用了这种强化治疗方案，我们并未产生显著的副作用。对于健康的年轻男性来说，每天高达12960次脉冲的剂量似乎是安全且可耐受的。
