Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands.
Int J Neuropsychopharmacol. 2009 Jun;12(5):643-50. doi: 10.1017/S1461145708009553. Epub 2008 Oct 17.
The aim of this treatment study was to evaluate the therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) over the right parietal cortex in depression. In a double-blind, sham-controlled design ten consecutive sessions of 2 Hz rTMS (inter-pulse interval 0.5 s) at 90% motor threshold to the right parietal cortex (2400 pulses per session) were applied to 34 patients with the primary diagnosis of DSM-IV depression and a score of > or =15 on the 17-item Hamilton Rating Scale for Depression (HAMD). The primary outcome measures were the percentage change from baseline on the 17-item HAMD scores after ten sessions, and the percentage of clinical (defined as > or =50% reduction in HAMD score) and partial clinical (defined as > or =30% reduction in HAMD score) responders. Reduction of HAMD scores in the real rTMS treatment (mean real+/-S.D., -19.9+/-32.5%) was not statistically different from the sham rTMS treatment (mean sham+/-S.D., -5.6+/-28.4%), and the number of clinical responders did not differ between treatments. However, a significant greater number of partial clinical responders were observed in the real (43.8%) compared to the sham rTMS treatment (6.3%). This study provides the first evidence showing that 2 Hz rTMS over the right parietal cortex may have antidepressant properties, and warrants further research.
本治疗研究旨在评估重复经颅磁刺激(rTMS)对右顶叶的治疗效果。在一项双盲、假刺激对照设计中,对 34 名符合 DSM-IV 抑郁诊断标准且汉密尔顿抑郁量表(HAMD)评分>或=15 分的患者,采用 2Hz rTMS(脉冲间隔 0.5s,刺激强度为 90%运动阈值),刺激右顶叶,共 10 个疗程,每个疗程 2400 个脉冲。主要的观察指标是治疗 10 个疗程后 HAMD17 项评分的基线百分比变化,以及临床(定义为 HAMD 评分降低>或=50%)和部分临床(定义为 HAMD 评分降低>或=30%)应答者的百分比。实际 rTMS 治疗组(HAMD 评分的实际变化+/-标准差,-19.9+/-32.5%)与假刺激 rTMS 治疗组(HAMD 评分的假变化+/-标准差,-5.6+/-28.4%)的 HAMD 评分降低没有统计学差异,两种治疗方法的临床应答者数量也没有差异。然而,实际 rTMS 治疗组(43.8%)部分临床应答者的数量明显多于假刺激 rTMS 治疗组(6.3%)。本研究首次提供了证据表明,2Hz rTMS 刺激右顶叶可能具有抗抑郁作用,值得进一步研究。