Department of Psychiatry, NPISTANBUL Neuropsychiatry Hospital, Istanbul, Turkey.
Clin EEG Neurosci. 2012 Oct;43(4):279-84. doi: 10.1177/1550059412449752.
We examined the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) in 419 patients with treatment-resistant depression. The patients received daily sessions of rTMS over the left prefrontal cortex as an adjuvant to pharmacotherapy. The rTMS intensity was set at 100% of the motor threshold and 25 Hz stimulation, with train duration of 2 seconds delivered at 30-second intervals. A full course comprised 1000 magnetic pulses. Depression was rated using the Hamilton Depression Rating Scale (HAMD) before and after treatment. Response was defined as a 50% reduction in the HAMD score. Patients with HAMD scores of less than 8 were considered to be in remission. The mean HAMD score for the study group decreased from 22.59 ± 5.92 to 10.50 ± 5.83 (P < .001). After the treatment period, 268 (64%) out of 419 patients demonstrated significant mood improvements, as indexed by a reduction of more than 50% on the HAMD score. In addition, 140 patients (33.4%) attained remission (HAMD score <8); and 11 patients achieved a partial response. Treatment was generally well tolerated, and no serious adverse effects were reported. In conclusion, high-frequency (25 Hz) rTMS was well tolerated and found to be statistically and clinically effective in patients with treatment-resistant depression. This study contributed to the existing evidence of the antidepressant effect of rTMS in the treatment of depression.
我们研究了高频重复经颅磁刺激（rTMS）在 419 例难治性抑郁症患者中的疗效。患者在药物治疗的基础上接受左前额皮质的每日 rTMS 治疗。rTMS 强度设定为电机阈值的 100%和 25 Hz 刺激，以 30 秒的间隔持续 2 秒的训练。一个疗程包括 1000 个磁脉冲。治疗前后使用汉密尔顿抑郁量表（HAMD）对抑郁进行评分。反应定义为 HAMD 评分降低 50%。HAMD 评分低于 8 分的患者被认为缓解。研究组的平均 HAMD 评分从 22.59 ± 5.92 降至 10.50 ± 5.83（P<.001）。治疗后，419 例患者中有 268 例（64%）表现出明显的情绪改善，HAMD 评分降低超过 50%。此外，140 例患者（33.4%）达到缓解（HAMD 评分<8）；11 例患者部分缓解。治疗总体上耐受良好，无严重不良事件报告。综上所述，高频（25 Hz）rTMS 耐受性良好，在难治性抑郁症患者中具有统计学和临床疗效。这项研究为 rTMS 在抑郁症治疗中的抗抑郁作用提供了现有证据。
