Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
Clin Neurophysiol. 2013 Jul;124(7):1309-20. doi: 10.1016/j.clinph.2013.01.014. Epub 2013 Feb 26.
To evaluate transcranial magnetic stimulation (TMS) measures of inhibition and excitation in obsessive-compulsive disorder (OCD), major depressive disorder (MDD) and schizophrenia (SCZ).
Paradigms included: short-interval cortical inhibition (SICI), cortical silent period (CSP), resting motor threshold, intracortical facilitation, and motor evoked potential amplitude. A literature search was performed using PubMed, Ovid Medline, Embase Psychiatry and PsycINFO 1990 through April 2012.
A significant Hedge's g was found for decreased SICI (g=0.572, 95% confidence interval [0.179, 0.966], p=0.004), enhanced intracortical facilitation (g=0.446, 95% confidence interval [0.042, 0.849], p=0.030) and decreased CSP (g=-0.466, 95% confidence interval [-0.881, -0.052], p=0.027) within the OCD population. For MDD, significant effect sizes were demonstrated for decreased SICI (g=0.641, 95% confidence interval [0.384, 0.898], p=0.000) and shortened CSP (g=-1.232, 95% confidence interval [-1.530, -0.933], p=0.000). In SCZ, a significant Hedge's g was shown for decreased SICI (g=0.476, 95% confidence interval [0.331, 0.620], p=0.000).
Inhibitory deficits are a ubiquitous finding across OCD, MDD, SCZ and enhancement of intracortical facilitation is specific to OCD.
Provides a clear platform from which diagnostic procedures can be developed.
评估强迫症（OCD）、重度抑郁症（MDD）和精神分裂症（SCZ）患者的经颅磁刺激（TMS）的抑制和兴奋测量值。
研究方案包括：短程皮质抑制（SICI）、皮质静息期（CSP）、静息运动阈值、皮质内易化和运动诱发电位振幅。通过 PubMed、Ovid Medline、Embase Psychiatry 和 PsycINFO 1990 年至 2012 年 4 月进行文献检索。
在 OCD 患者中，发现 SICI 降低（g=0.572，95%置信区间 [0.179, 0.966]，p=0.004）、皮质内易化增强（g=0.446，95%置信区间 [0.042, 0.849]，p=0.030）和 CSP 降低（g=-0.466，95%置信区间 [-0.881, -0.052]，p=0.027）的 Hedge's g 有显著差异。对于 MDD，SICI 降低（g=0.641，95%置信区间 [0.384, 0.898]，p=0.000）和 CSP 缩短（g=-1.232，95%置信区间 [-1.530, -0.933]，p=0.000）的效应大小具有显著差异。在 SCZ 中，SICI 降低（g=0.476，95%置信区间 [0.331, 0.620]，p=0.000）的 Hedge's g 有显著差异。
抑制缺陷是 OCD、MDD、SCZ 患者的普遍发现，而皮质内易化的增强是 OCD 特有的。
为诊断程序的开发提供了明确的平台。
