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完美搭配:非侵入性脑刺激与心理治疗。

A perfect match: noninvasive brain stimulation and psychotherapy.

作者信息

Bajbouj Malek, Padberg Frank

机构信息

Department of Psychiatry, Center for Affective Sciences (CAS), Charité and Freie Universität Berlin, Campus Benjamin Franklin (CBF), Eschenallee 3, 14050, Berlin, Germany,

出版信息

Eur Arch Psychiatry Clin Neurosci. 2014 Nov;264 Suppl 1:S27-33. doi: 10.1007/s00406-014-0540-6. Epub 2014 Sep 25.

Abstract

One out of four patients with a psychiatric disorder does not tolerate or sufficiently respond to standard treatments, leading to impaired quality of life, significant morbidity and mortality, as well as high socioeconomic costs. There is increasing evidence that-apart from psychopharmacologic and psychotherapeutic interventions-targeted modulation of neural networks by brain stimulation techniques might serve as a third treatment modality. In the whole spectrum of treatment modalities, combined approaches are often used for difficult-to-treat patients. They may be superior strategies compared to monotherapy and could possible also include brain stimulation interventions. However, systematic research is lacking for the latter issue. Particularly, noninvasive brain stimulation (NIBS), e.g., transcranial direct current stimulation (tDCS) can be easily combined with psychotherapy approaches. Here, we introduce NIBS techniques for priming and augmenting psychotherapy, review preliminary data and propose a future research strategy. Interestingly, this strategy parallels the promising development in neurology and neurorehabilitation where tDCS is currently combined with functional training tasks to enhance motor or cognitive performance.

摘要

四分之一的精神疾病患者无法耐受标准治疗或对其反应不佳,导致生活质量受损、发病率和死亡率显著升高,以及高昂的社会经济成本。越来越多的证据表明,除了心理药物和心理治疗干预外,通过脑刺激技术对神经网络进行靶向调节可能成为第三种治疗方式。在整个治疗方式范围内,联合方法常用于治疗困难的患者。与单一疗法相比,它们可能是更优的策略,并且可能还包括脑刺激干预。然而,对于后一个问题缺乏系统研究。特别是,非侵入性脑刺激(NIBS),例如经颅直流电刺激(tDCS)可以很容易地与心理治疗方法相结合。在此,我们介绍用于启动和增强心理治疗的NIBS技术,回顾初步数据并提出未来的研究策略。有趣的是,这一策略与神经病学和神经康复领域的蓬勃发展相平行,目前tDCS正与功能训练任务相结合以提高运动或认知表现。

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