Kirov George, Ebmeier Klaus P, Scott Allan I F, Atkins Maria, Khalid Najeeb, Carrick Lucy, Stanfield Andrew, O'Carroll Ronan E, Husain Mustafa M, Lisanby Sarah H
Cardiff University, Henry Wellcome Building, Heath Park, Cardiff, UK.
Br J Psychiatry. 2008 Aug;193(2):152-5. doi: 10.1192/bjp.bp.107.044362.
Magnetic seizure therapy, in which seizures are elicited with a high-frequency magnetic field, is under development as a new treatment for major depressive disorder. Its use may be justified if it produces the antidepressant effects of electroconvulsive therapy (ECT), coupled with limited cognitive side-effects.
To evaluate the usefulness of a new 100 Hz magnetic seizure therapy device.
We induced seizures with 100 Hz magnetic transcranial stimulation in 11 patients with major depressive disorder during one session of a regular course of ECT. Recovery times after seizures induced by magnetic seizure therapy and ECT were compared.
Seizures could be elicited in 10 of the 11 patients. Stimulation over the vertex produced tonic-clonic activity on 9 out of 11 occasions. Stimulation over the prefrontal midpoint elicited seizures on 3 out of 7 occasions. The mean duration of magnetically induced seizures was 31.3 s, ranging from 10 to 86 s. All patients had an exceptionally quick recovery of orientation: mean of 7 min 12 s (s.d.=2 min 7 s, range 4 min 20 s to 9 min 41 s). The recovery times were on average 15 min 35 s shorter with magnetic seizure therapy than with ECT in the same patients (paired-samples t-test: P<0.0001). Patients reported feeling less confused after magnetic seizure therapy. Side-effects were confined to myoclonic movements, associated with the use of etomidate.
The new 100 Hz magnetic stimulator elicits seizures in the majority of patients when administered over the vertex. Magnetic seizure therapy was associated with shorter recovery times and less confusion following treatment. Subsequent work will be required to assess the safety and effectiveness of magnetic seizure therapy in the treatment of depression.
磁惊厥治疗是一种利用高频磁场引发惊厥的治疗方法，目前正在开发用于治疗重度抑郁症。如果它能产生电休克疗法（ECT）的抗抑郁效果，同时认知副作用有限，那么其应用可能是合理的。
评估一种新型100Hz磁惊厥治疗设备的效用。
我们在11例重度抑郁症患者进行常规ECT疗程的一次治疗中，采用100Hz磁刺激经颅刺激诱发惊厥。比较磁惊厥治疗和ECT诱发惊厥后的恢复时间。
11例患者中有10例可诱发惊厥。在头顶进行刺激时，11次中有9次产生强直-阵挛活动。在前额中点进行刺激时，7次中有3次诱发惊厥。磁诱导惊厥的平均持续时间为31.3秒，范围为10至86秒。所有患者的定向恢复都异常迅速：平均为7分12秒（标准差=2分7秒，范围为4分20秒至9分41秒）。在同一患者中，磁惊厥治疗后的恢复时间平均比ECT短15分35秒（配对样本t检验：P<0.0001）。患者报告磁惊厥治疗后感觉困惑较少。副作用仅限于与依托咪酯使用相关的肌阵挛运动。
新型100Hz磁刺激器在头顶进行刺激时，能在大多数患者中诱发惊厥。磁惊厥治疗与治疗后较短的恢复时间和较少的困惑相关。后续需要开展工作来评估磁惊厥治疗在抑郁症治疗中的安全性和有效性。
