Philip Noah S, Ridout Samuel J, Albright Sarah E, Sanchez George, Carpenter Linda L
Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, Rhode Island, USA.
Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.
J Trauma Stress. 2016 Feb;29(1):93-6. doi: 10.1002/jts.22065. Epub 2016 Jan 7.
Current treatment options for posttraumatic stress disorder (PTSD) offer modest benefits, underscoring the need for new treatments. Repetitive transcranial magnetic stimulation (rTMS) depolarizes neurons in a targeted brain region with magnetic fields typically pulsed at low (1 Hz) or high (10 Hz) frequency to relieve major depressive disorder (MDD). Prior work suggests an intermediate pulse frequency, 5 Hz, is also efficacious for treating comorbid depressive and anxiety symptoms. In this chart review study, we systematically examined the clinical and safety outcomes in 10 patients with comorbid MDD and PTSD syndromes who received 5-Hz rTMS therapy at the Providence VA Medical Center Neuromodulation Clinic. Self-report scales measured illness severity prior to treatment, after every 5 treatments, and upon completion of treatment. Results showed significant reduction in symptoms of PTSD (p = .003, effect size = 1.12, 8/10 with reliable change) and MDD (p = .005, effect size = 1.09, 6/10 with reliable change). Stimulation was well tolerated and there were no serious adverse events. These data indicate 5-Hz rTMS may be a useful option to treat these comorbid disorders. Larger, controlled trials are needed to confirm the benefits of 5-Hz protocols observed in this pilot study.
创伤后应激障碍（PTSD）的现有治疗方案效果有限，这凸显了对新治疗方法的需求。重复经颅磁刺激（rTMS）通过磁场使目标脑区的神经元去极化，磁场通常以低频率（1Hz）或高频率（10Hz）脉冲，以缓解重度抑郁症（MDD）。先前的研究表明，中间脉冲频率5Hz对于治疗共病的抑郁和焦虑症状也有效。在这项图表回顾研究中，我们系统地检查了10例患有共病MDD和PTSD综合征的患者在普罗维登斯退伍军人事务医疗中心神经调节诊所接受5Hz rTMS治疗后的临床和安全性结果。通过自我报告量表在治疗前、每5次治疗后以及治疗结束时测量疾病严重程度。结果显示，PTSD症状（p = 0.003，效应大小 = 1.12，8/10有可靠变化）和MDD症状（p = 0.005，效应大小 = 1.09，6/10有可靠变化）显著减轻。刺激耐受性良好，没有严重不良事件。这些数据表明，5Hz rTMS可能是治疗这些共病障碍的有用选择。需要进行更大规模的对照试验来证实本试点研究中观察到的5Hz方案的益处。
