Département Recherche et Développement, Centre Hospitalier Esquirol, 15 rue du Docteur Marcland, 87025 Limoges cedex, France.
J Affect Disord. 2013 Sep 5;150(2):677-81. doi: 10.1016/j.jad.2013.03.024. Epub 2013 May 11.
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive method of brain stimulation used in the treatment of drug-resistant major depressive disorder (MDD). It has been suggested that the efficacy of rTMS decreases with the age of the patient, but the data are contradictory. Here, we analyze in our clinical setting the efficacy of a 3-week rTMS treatment in drug-resistant MDD during a 3 month period and the potential influence of age on this efficacy.
Stimulation consisted of 15 sessions of rTMS over the dorsolateral prefrontal cortex. Clinical evaluations included the Hamilton Depression Rating Scale (HDRS), and the Beck Depression Inventory (BDI) at baseline, after 3 weeks of treatment, and 1 month and 3 months after the last session.
Data from 93 patients issued from the 178 patients active file were analyzed. The antidepressant effect observed in the two age groups (<65 and ≥65) did not differ at the end of the treatment and 3 months later, with a comparable number of responders (50% decrease in HDRS score from baseline) (53.3% for age <65 versus 46.7% for age ≥65, p=0.51). The treatment had a significant effect over time. We found no evidence of the age affecting outcome at 3 months after the last session.
Previous antidepressant treatments, and therapeutic drug use modifications after rTMS treatment, degree of pharmaco-resistance or duration of current episode are not reported.
RTMS of the DFPLC is effective as an add-on treatment for cases of pharmacologically refractory major depression, independent of the patient age.
重复经颅磁刺激（rTMS）是一种用于治疗耐药性重度抑郁症（MDD）的非侵入性脑刺激方法。有人认为 rTMS 的疗效会随患者年龄的增长而降低，但数据存在矛盾。在这里，我们在临床环境中分析了在 3 个月的时间内，接受为期 3 周 rTMS 治疗的耐药性 MDD 患者的疗效，以及年龄对这种疗效的潜在影响。
刺激包括背外侧前额叶皮层的 15 次 rTMS 治疗。临床评估包括基线时、治疗 3 周后以及最后一次治疗后 1 个月和 3 个月的汉密尔顿抑郁量表（HDRS）和贝克抑郁量表（BDI）。
对来自 178 名活跃患者档案中的 93 名患者的数据进行了分析。在治疗结束时和 3 个月后，两个年龄组（<65 岁和≥65 岁）观察到的抗抑郁效果没有差异，应答者数量相当（HDRS 评分从基线下降 50%）（<65 岁年龄组为 53.3%，≥65 岁年龄组为 46.7%，p=0.51）。治疗随着时间的推移有显著的效果。我们没有发现年龄在最后一次治疗后 3 个月影响结果的证据。
没有报告之前的抗抑郁治疗、rTMS 治疗后治疗药物的使用修改、药物抵抗程度或当前发作的持续时间。
DFPLC 的 rTMS 是一种有效的附加治疗方法，可用于治疗药物难治性重度抑郁症，与患者年龄无关。
