Monash Alfred Psychiatry Research Centre, The Alfred and Monash University School of Psychology and Psychiatry, Victoria, Australia.
J Affect Disord. 2012 Feb;136(3):1243-6. doi: 10.1016/j.jad.2011.08.005. Epub 2011 Aug 27.
Repetitive transcranial magnetic stimulation (rTMS) is increasingly being investigated in clinical settings for the treatment of neurological and psychiatric disorders such as dystonia, schizophrenia, and major depressive disorder (MDD). Using near infra-red spectroscopy (NIRS), very short trains of rTMS have previously been shown to modulate cortical blood oxygenation.
In order to investigate the effect of longer, clinically relevant trains of 1 Hz rTMS on oxy-hemoglobin (HbO) at prefrontal cortex, the current study applied ten minute trains of rTMS at both subthreshold and suprathreshold intensities.
A similar profile of oxygenation change was observed during the beginning 30-40 s of the trains, however for the remainder, subthreshold rTMS returned to baseline while the suprathreshold TMS resulted in a long period of reduced oxygenation.
Small sample size.
The differences observed may be a product of changes in HbO requirements by inhibitory/excitatory neural circuits, either by reduced HbO demand or by increased HbO consumption, while sustained HbO reduction may be a consequence of a modulation of vaso-motor reactivity. This study has implications for understanding the mechanisms involved in the physiological changes evoked by rTMS and efficacious clinical application of rTMS in disorders such as MDD.
重复经颅磁刺激（rTMS）在临床环境中越来越多地被用于治疗神经和精神疾病，如肌张力障碍、精神分裂症和重度抑郁症（MDD）。使用近红外光谱（NIRS），以前已经证明非常短的 rTMS 脉冲可以调节皮质血氧。
为了研究更长的、临床相关的 1 Hz rTMS 脉冲对前额叶皮质氧合血红蛋白（HbO）的影响，本研究应用了亚阈值和超阈值强度的 10 分钟 rTMS 脉冲。
在脉冲的前 30-40 秒内观察到相似的氧合变化特征，然而，在其余时间内，亚阈值 rTMS 恢复到基线，而超阈值 TMS 导致长时间的氧合减少。
样本量小。
观察到的差异可能是抑制/兴奋神经回路的 HbO 需求变化的结果，可能是 HbO 需求减少或消耗增加，而持续的 HbO 减少可能是血管运动反应调节的结果。这项研究对于理解 rTMS 引起的生理变化的机制以及 rTMS 在 MDD 等疾病中的有效临床应用具有重要意义。
