Dell'Osso Bernardo, Altamura A Carlo
University of Milan, Milano (I), Dept of Neurosciences, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Via F. Sforza 28, 20122, Milano (I), Italy.
Clin Pract Epidemiol Ment Health. 2014 Oct 3;10:92-3. doi: 10.2174/1745017901410010092. eCollection 2014.
Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are non-invasive brain stimulation techniques that, by means of magnetic fields and low intensity electrical current, respectively, aim to interefere with and modulate cortical excitability, at the level of dorsolateral prefrontal cortex, in patients with major depression and poor response to standard antidepressants. While the clinical efficacy of TMS in major depression has been extensively investigated over the last 10 years, tDCS has attracted research interest only in the last years, with fewer randomized clinical trials (RCTs) in the field. Nevertheless, in spite of the different rationale and mechanism of action of the two techniques, tDCS recent acquisitions, in relation to the treatment of major depression, seem to parallel those previously obtained with TMS, in terms of treatment duration to achieve optimal benefit and patient's history of drug-resistance. After briefly introducing the two techniques, the article examines possible common pathways of clinical use for TMS and tDCS, emerging from recent RCTs and likely orienting future investigation with non invasive brain stimulation for the treatment of major depression.
经颅磁刺激（TMS）和经颅直流电刺激（tDCS）是非侵入性脑刺激技术，分别通过磁场和低强度电流，旨在干扰和调节重度抑郁症且对标准抗抑郁药反应不佳患者背外侧前额叶皮质水平的皮质兴奋性。在过去10年里，TMS在重度抑郁症中的临床疗效已得到广泛研究，而tDCS只是在最近几年才引起研究兴趣，该领域的随机临床试验（RCT）较少。然而，尽管这两种技术的原理和作用机制不同，但就实现最佳疗效的治疗持续时间和患者耐药史而言，tDCS在重度抑郁症治疗方面的最新研究成果似乎与之前TMS的研究成果相似。在简要介绍这两种技术后，本文探讨了TMS和tDCS在临床应用中可能的共同途径，这些途径源于最近的RCT，并可能为未来使用非侵入性脑刺激治疗重度抑郁症的研究指明方向。
