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为什么现在是时候将认知事件相关电位应用于精神疾病的治疗中了。

Why it is time to develop the use of cognitive event-related potentials in the treatment of psychiatric diseases.

机构信息

Laboratory of Medical Psychology, and Addictology, ULB Neuroscience institute (UNI), Université Libre de, Bruxelles, Brussels, Belgium.

出版信息

Neuropsychiatr Dis Treat. 2013;9:1835-45. doi: 10.2147/NDT.S53687. Epub 2013 Nov 28.

Abstract

The relapse rate for many psychiatric disorders is staggeringly high, indicating that treatment methods combining psychotherapy with neuropharmacological interventions are not entirely effective. Therefore, in psychiatry, there is a current push to develop alternatives to psychotherapy and medication-based approaches. Cognitive deficits have gained considerable importance in the field as critical features of mental illness, and it is now believed that they might represent valid therapeutic targets. Indeed, an increase in cognitive skills has been shown to have a long-lasting, positive impact on the patients' quality of life and their clinical symptoms. We hereby present four principal arguments supporting the use of event-related potentials (ERP) that are derived from electroencephalography, which allow the identification of specific neurocognitive deficiencies in patients. These arguments could assist psychiatrists in the development of individualized, targeted therapy, as well as a follow-up and rehabilitation plan specific to each patient's deficit. Furthermore, they can be used as a tool to assess the possible benefits of combination therapy, consisting of medication, psychotherapy, and "ERP-oriented cognitive rehabilitation". Using this strategy, specific cognitive interventions could be planned based on each patient's needs, for an "individualized" or "personalized" therapy, which may have the potential to reduce relapse rates for many psychiatric disorders. The implementation of such a combined approach would require intense collaboration between psychiatry departments, clinical neurophysiology laboratories, and neuropsychological rehabilitation centers.

摘要

许多精神疾病的复发率高得惊人,这表明将心理疗法与神经药理学干预相结合的治疗方法并非完全有效。因此,在精神病学领域,目前正在努力开发替代心理疗法和药物治疗方法。认知缺陷作为精神疾病的关键特征,在该领域受到了相当大的重视,现在人们认为它们可能是有效的治疗靶点。事实上,认知技能的提高已被证明对患者的生活质量和临床症状有持久的积极影响。我们在此提出了四个主要论点,支持使用源自脑电图的事件相关电位 (ERP),这些电位可以识别患者的特定神经认知缺陷。这些论点可以帮助精神科医生制定针对每个患者缺陷的个体化、靶向治疗以及随访和康复计划。此外,它们可以用作评估药物治疗、心理治疗和“ERP 导向的认知康复”相结合的治疗可能带来的益处的工具。使用这种策略,可以根据每个患者的需求计划特定的认知干预措施,从而实现“个体化”或“个性化”治疗,这有可能降低许多精神疾病的复发率。这种联合方法的实施需要精神病科、临床神经生理学实验室和神经心理康复中心之间的密切合作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ee0/3849081/cdaa2e9546b1/ndt-9-1835Fig1.jpg

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