经颅磁刺激治疗伴有精神病性症状的重度抑郁症患者的幻听：一年随访
Treatment of auditory verbal hallucinations with transcranial magnetic stimulation in a patient with psychotic major depression: one-year follow-up.
作者信息
Freitas Catarina, Pearlman Chester, Pascual-Leone Alvaro
机构信息
Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
出版信息
Neurocase. 2012 Feb;18(1):57-65. doi: 10.1080/13554794.2010.547864. Epub 2011 Jun 28.
Auditory verbal hallucinations (AVH) in patients with schizophrenia can respond to repetitive transcranial magnetic stimulation (TMS). We report the therapeutic utility of rTMS in a 48-year-old patient with a 20-year history of severe depression (five suicidal gestures and previous failure of ECT) and internal AVH. First, 20 Hz rTMS to the left prefrontal cortex for 3 weeks significantly improved depression (BDI-II: 89% change, lasting 14 months along with weekly/bi-weekly maintenance treatments), but AVH remained unchanged. The patient also underwent a further course of the left temporo-parietal 1 Hz rTMS and amelioration of AVH severity was achieved (PSYRATS-AH: 53% change) and maintained at 1-year follow-up. AVH respond to rTMS in disorders other than schizophrenia. Furthermore, targeted rTMS to different brain regions can address diverse symptoms in neuropsychiatric conditions.
精神分裂症患者的幻听可以对重复经颅磁刺激（TMS）产生反应。我们报告了重复经颅磁刺激（rTMS）对一名48岁患者的治疗效果，该患者有20年严重抑郁症病史（有5次自杀企图，之前接受电休克治疗无效）且存在内在性幻听。首先，对左侧前额叶皮层进行为期3周的20赫兹rTMS治疗，显著改善了抑郁症症状（贝克抑郁量表第二版[BDI-II]：变化89%，在每周/每两周一次的维持治疗下持续了14个月），但幻听症状未改变。该患者随后又接受了左侧颞顶叶1赫兹rTMS的进一步治疗疗程，幻听严重程度得到改善（阳性和阴性症状评定量表-幻听亚量表[PSYRATS-AH]：变化53%），并在1年随访中保持稳定。幻听在精神分裂症以外的疾病中也对rTMS有反应。此外，针对不同脑区的靶向rTMS可以解决神经精神疾病中的多种症状。
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