Pigot Melissa, Loo Colleen, Sachdev Perminder
School of Psychiatry, University of New South Wales, Black Dog Institute, Prince of Wales Hospital, Randwick, NSW 2031, Australia.
Expert Rev Neurother. 2008 Oct;8(10):1449-55. doi: 10.1586/14737175.8.10.1449.
Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive and generally well-tolerated method of focally stimulating brain regions. It has been shown to be efficacious in the treatment for depression, but only to a limited degree. It has also been investigated for the treatment of some anxiety disorders, particularly obsessive-compulsive disorder, post-traumatic stress disorder and panic disorder. While anecdotal reports and open studies have suggested a therapeutic role for rTMS in anxiety disorders, controlled studies, which have varied greatly in terms of rTMS administration, have not shown it to be superior to placebo. Furthermore, reports in animal models of anxiety have not been consistent. Therefore, to date, there is no convincing evidence for the clinical role of rTMS in anxiety disorders. Further research is needed, drawing on advances in our understanding of pathological neurocircuitry in anxiety disorders and the mechanisms of action by which rTMS may alter that neurocircuitry. With advances in neuroimaging technology, this understanding is likely to be more accessible than it has been in the past.
重复经颅磁刺激（rTMS）是一种非侵入性的、通常耐受性良好的局部刺激脑区的方法。它已被证明在治疗抑郁症方面有效，但程度有限。它也被研究用于治疗一些焦虑症，特别是强迫症、创伤后应激障碍和惊恐障碍。虽然轶事报道和开放性研究表明rTMS在焦虑症中具有治疗作用，但在rTMS给药方面差异很大的对照研究并未表明它优于安慰剂。此外，焦虑症动物模型的报道并不一致。因此，迄今为止，没有令人信服的证据表明rTMS在焦虑症中的临床作用。需要进一步研究，借鉴我们对焦虑症病理神经回路的理解进展以及rTMS可能改变该神经回路的作用机制。随着神经成像技术的进步，这种理解可能比过去更容易获得。
