Fitzgerald Paul
Alfred Psychiatry Research Centre, The Alfred and Monash University School of Psychology, Psychiatry and Psychological Medicine, VIC, Australia.
Australas Psychiatry. 2008 Jun;16(3):183-90. doi: 10.1080/10398560701874291.
The aim of this paper was to review the development of repetitive transcranial magnetic stimulation (rTMS), magnetic seizure therapy (MST), vagal nerve stimulation (VNS), deep brain stimulation (DBS) and other recent brain stimulation techniques for their potential use in the treatment of a range of psychiatric disorders.
A considerable number of studies have been conducted to investigate the efficacy of rTMS. Although there are considerable problems with this research base, globally the studies suggest that rTMS has antidepressant efficacy. However, more research is required to define the most effective way of applying this technique. There is a much smaller research base supporting the use of VNS and to date the research suggests that only a minority of patients benefit from this procedure. Considerably more research is required in the use of the other techniques which at this stage have been tested only to a very small degree. It is likely that one, and possibly a number, of the new brain stimulation techniques will become available clinically in the psychiatric armamentarium in the coming years. However, considerable research is still required to establish efficacy and define the appropriate place in clinical practice for these treatment approaches.
本文旨在综述重复经颅磁刺激(rTMS)、磁休克治疗(MST)、迷走神经刺激(VNS)、深部脑刺激(DBS)以及其他近期脑刺激技术的发展情况,探讨其在一系列精神疾病治疗中的潜在应用。
已经开展了大量研究来调查rTMS的疗效。尽管该研究基础存在相当多问题,但全球范围内的研究表明rTMS具有抗抑郁疗效。然而,需要更多研究来确定应用该技术的最有效方式。支持使用VNS的研究基础要小得多,迄今为止的研究表明只有少数患者能从该治疗中获益。对于其他技术的使用,需要进行更多得多的研究,目前这些技术仅在非常小的程度上进行了测试。未来几年,很可能一种或多种新的脑刺激技术将在临床精神科治疗手段中可用。然而,仍需要大量研究来确定这些治疗方法的疗效,并明确其在临床实践中的合适位置。