Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Victoria, Australia.
Depress Anxiety. 2013 Feb;30(2):129-36. doi: 10.1002/da.22005. Epub 2012 Oct 18.
Electroconvulsive therapy (ECT) is a very commonly used treatment for patients with severe and treatment-resistant depression. Although effective, this treatment is complicated by a number of side effects including cognitive impairment motivating attempts to develop treatment alternatives. Magnetic seizure therapy (MST) is a brain stimulation technique using a high-powered transcranial magnetic stimulation device to produce therapeutic seizures. Preliminary research suggests that MST has antidepressant activity in the absence of cognitive side effects. The aim of this study was therefore to investigate the therapeutic efficacy and cognitive profile of MST provided at high frequency (100 Hz) and potentially longer stimulation trains and longer treatment courses than have been previously investigated.
Thirteen patients participated in an open-label clinical trial of up to 18 treatment sessions with 100-Hz MST. Assessments of depression severity and cognitive functioning were performed before and after treatment.
Of the 13 patients who completed the study, five met clinical response criteria at study end. There was an overall group reduction in depression severity and no evidence of any impairment of orientation, memory, or other elements of cognition after MST treatment. The major limitation of the study was its lack of sham control.
In conclusion, MST shows antidepressant efficacy without apparent cognitive side effects. However, substantial research is required to understand the optimal conditions for stimulation and to compare MST to established treatments including ECT.
电抽搐治疗（ECT）是一种非常常用于治疗严重和治疗抵抗性抑郁症患者的治疗方法。尽管有效，但这种治疗方法有许多副作用，包括认知障碍，这促使人们试图开发替代治疗方法。磁惊厥治疗（MST）是一种脑刺激技术，使用高功率经颅磁刺激设备产生治疗性惊厥。初步研究表明，MST 在没有认知副作用的情况下具有抗抑郁作用。因此，本研究的目的是研究高频（100Hz）和潜在更长刺激时间和更长治疗时间的 MST 的治疗效果和认知特征，这些时间都超过了以前的研究。
13 名患者参加了一项多达 18 次治疗的开放性临床试验，接受 100Hz MST 治疗。在治疗前后进行抑郁严重程度和认知功能的评估。
在完成研究的 13 名患者中，有 5 名在研究结束时达到临床反应标准。总体上，患者的抑郁严重程度有所减轻，MST 治疗后没有定向、记忆或认知其他方面的损害证据。该研究的主要局限性是缺乏假手术对照。
总之，MST 显示出抗抑郁疗效，没有明显的认知副作用。然而，需要进行大量研究以了解刺激的最佳条件，并将 MST 与包括 ECT 在内的既定治疗方法进行比较。
