Serafini Gianluca, Pompili Maurizio, Belvederi Murri Martino, Respino Matteo, Ghio Lucio, Girardi Paolo, Fitzgerald Paul B, Amore Mario
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
Neuropsychobiology. 2015;71(3):125-39. doi: 10.1159/000381351. Epub 2015 Apr 25.
Major depressive disorder (MDD) is a disabling illness associated with significant functional and psychosocial impairment. Although many psychopharmacological agents are currently available for its treatment, many MDD patients suffer from treatment-resistant depression (TRD).
A systematic review of the current literature (Pubmed/Medline, Scopus and ScienceDirect search) has been conducted with the primary aim to investigate the role of repetitive transcranial magnetic stimulation (rTMS) in improving neurocognition in patients with TRD. Studies were included according to the following criteria: (a) being an original paper in a peer-reviewed journal and (b) having analyzed the effect of rTMS on neurocognitive functioning in TRD.
The combined search strategy yielded a total of 91 articles, of which, after a complete analysis, 22 fulfilled our inclusion criteria. Based on the main findings, most of the selected studies suggested the existence of a trend towards improvements in the neurocognitive profile using rTMS. Negative findings have also been reported. However, most studies were limited by their small sample size or included mixed samples, or the adopted single-blind designs potentially biased the blinding of the study design.
rTMS is a noninvasive brain stimulation that may be considered a valuable and promising technique for cognitive enhancement in TRD.
重度抑郁症（MDD）是一种致残性疾病，与显著的功能和心理社会损害相关。尽管目前有许多精神药物可用于治疗，但许多MDD患者患有难治性抑郁症（TRD）。
对当前文献（通过PubMed/Medline、Scopus和ScienceDirect搜索）进行了系统综述，主要目的是研究重复经颅磁刺激（rTMS）在改善TRD患者神经认知方面的作用。根据以下标准纳入研究：（a）为同行评审期刊上的原创论文；（b）分析了rTMS对TRD患者神经认知功能的影响。
综合搜索策略共获得91篇文章，经过全面分析，其中22篇符合我们的纳入标准。基于主要研究结果，大多数所选研究表明使用rTMS存在神经认知状况改善的趋势。也有负面研究结果报道。然而，大多数研究受到样本量小或纳入混合样本的限制，或者所采用的单盲设计可能使研究设计的盲法产生偏差。
rTMS是一种非侵入性脑刺激，可被认为是一种用于改善TRD患者认知的有价值且有前景的技术。
