TMS Treatment and Research Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA.
J ECT. 2012 Jun;28(2):98-103. doi: 10.1097/YCT.0b013e31824532c8.
Transcranial magnetic stimulation (TMS) uses a medical device that applies magnetic pulses noninvasively to the cortex of the brain to depolarize neurons. We tested its safety and efficacy in young persons with a diagnosis of attention-deficit/hyperactivity disorder (ADHD).
Transcranial magnetic stimulation was applied to the right prefrontal cortex at 10 Hz, at 100% of the observed motor threshold, for 2000 pulses per session, in a 10-session course over 2 weeks in a sham-controlled crossover design (n=9). There was 1 week of no TMS between the active and sham phases. Safety of TMS was assessed by means of serial audiometry, neuropsychological testing, and electroencephalogram (EEG) at baseline, midpoint, and end point of the study. Efficacy was assessed as a primary outcome by changes in the Clinical Global Impression-Improvement (CGI-I) scale and secondarily by change in the ADHD-IV scale.
Transcranial magnetic stimulation was found to be safe, with no serious adverse events and no discontinuations due to adverse effects. All randomized subjects completed the full course of sessions. There were no significant changes in auditory thresholds or in electroencephalographic assessments. Neuropsychological testing showed no significant differences between active and sham groups. There was an overall significant improvement in the clinical global impression of improvement and the ADHD-IV scales across the study phases (active and sham TMS combined; P<0.01), but the change between active and sham TMS phases did not differ.
Transcranial magnetic stimulation was found to be safe, with no serious adverse events observed in this pilot study. Improvement in symptoms was observed across the combined phases of the study, although there was no difference between the active and sham forms of TMS. Effects of clinical importance should be further assessed in larger controlled studies.
经颅磁刺激（TMS）使用一种医疗设备，通过非侵入性地向大脑皮层施加磁场脉冲来使神经元去极化。我们在被诊断患有注意缺陷多动障碍（ADHD）的年轻人中测试了其安全性和有效性。
在 2 周的时间内，以假对照交叉设计（n=9），共进行 10 个疗程，每个疗程 2000 个脉冲，每个疗程 10 秒，频率为 10 Hz，刺激强度为观察到的运动阈值的 100%，应用于右侧前额叶皮质。在活动期和假刺激期之间有 1 周的时间没有 TMS。通过连续听力测试、神经心理学测试和脑电图（EEG）在研究的基线、中点和终点评估 TMS 的安全性。采用临床总体印象改善量表（CGI-I）的变化作为主要疗效指标，其次采用 ADHD-IV 量表的变化作为次要疗效指标来评估疗效。
TMS 被证明是安全的，没有严重的不良事件，也没有因不良反应而中断治疗。所有随机入组的受试者都完成了整个疗程。听觉阈值或脑电图评估没有显著变化。神经心理学测试显示活动组和假刺激组之间没有显著差异。在整个研究阶段（包括 TMS 活动期和假刺激期），临床总体印象改善量表和 ADHD-IV 量表均有显著改善（P<0.01），但 TMS 活动期和假刺激期之间的变化没有差异。
在本初步研究中，TMS 被发现是安全的，没有观察到严重的不良事件。在研究的各个阶段都观察到了症状的改善，尽管 TMS 的活动形式和假刺激形式之间没有差异。应在更大规模的对照研究中进一步评估具有临床重要意义的效果。
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