Mishra Biswa Ranjan, Sarkar Sukanto, Praharaj Samir Kumar, Mehta Varun S, Diwedi Shreyansh, Nizamie S Haque
Department of Psychiatry, M.K.C.G. Medical College, Berhampur, Orissa, India.
Ann Indian Acad Neurol. 2011 Oct;14(4):245-51. doi: 10.4103/0972-2327.91935.
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive and relatively painless tool that has been used to study various cognitive functions as well as to understand the brain-behavior relationship in normal individuals as well as in those with various neuropsychiatric disorders. It has also been used as a therapeutic tool in various neuropsychiatric disorders because of its ability to specifically modulate distinct brain areas. Studies have shown that repeated stimulation at low frequency produces long-lasting inhibition, which is called as long-term depression, whereas repeated high-frequency stimulation can produce excitation through long-term potentiation. This paper reviews the current status of rTMS as an investigative and therapeutic modality in various neuropsychiatric disorders. It has been used to study the cortical and subcortical functions, neural plasticity and brain mapping in normal individuals and in various neuropsychiatric disorders. rTMS has been most promising in the treatment of depression, with an overall milder adverse effect profile compared with electroconvulsive therapy. In other neuropsychiatric disorders such as schizophrenia, mania, epilepsy and substance abuse, it has been found to be useful, although further studies are required to establish therapeutic efficacy. It appears to be ineffective in the treatment of obsessive compulsive disorder. There is a paucity of studies of efficacy and safety of rTMS in pediatric and geriatric population. Although it appears safe, further research is required to optimize its efficacy and reduce the side-effects. Magnetic seizure therapy, which involves producing seizures akin to electroconvulsive therapy, appears to be of comparable efficacy in the treatment of depression with less cognitive adverse effects.
重复经颅磁刺激（rTMS）是一种非侵入性且相对无痛的工具，已被用于研究各种认知功能，以及了解正常个体和患有各种神经精神疾病的个体的脑-行为关系。由于其能够特异性地调节不同脑区，它也被用作各种神经精神疾病的治疗工具。研究表明，低频重复刺激会产生持久的抑制作用，即所谓的长时程抑制，而高频重复刺激则可通过长时程增强产生兴奋作用。本文综述了rTMS作为各种神经精神疾病的一种研究和治疗方式的现状。它已被用于研究正常个体和各种神经精神疾病中的皮质和皮质下功能、神经可塑性和脑图谱。rTMS在抑郁症治疗方面最具前景，与电休克治疗相比，其总体不良反应较轻。在其他神经精神疾病如精神分裂症、躁狂症、癫痫和药物滥用中，已发现它是有用的，尽管需要进一步研究来确定其治疗效果。它在强迫症治疗中似乎无效。关于rTMS在儿科和老年人群中的疗效和安全性的研究很少。尽管它看起来是安全的，但仍需要进一步研究以优化其疗效并减少副作用。磁休克治疗涉及产生类似于电休克治疗的癫痫发作，在治疗抑郁症方面似乎具有相当的疗效，且认知不良反应较少。
