Shin Hae-Won, Youn Young C, Chung Sun J, Sohn Young H
Department of Neurology, Chung-Ang University College of Medicine, Seoul, South Korea.
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
J Neurol. 2016 Jul;263(7):1442-8. doi: 10.1007/s00415-016-8160-x. Epub 2016 May 13.
Major depressive disorder (MDD) occurs in a small proportion of patients with Parkinson's disease (PD) and reduces their quality of life. We performed a randomized sham-controlled study to evaluate the effect of high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) on MDD in patients with PD. Ten patients participated to a real-rTMS group and eight patients to a sham-rTMS group. Evaluations were performed at baseline, 2 and 6 weeks after rTMS treatment. All participants underwent examinations of depression rating scales, including the Hamilton Rating Scale, the Montgomery-Asberg Depression Rating Scale (MADRS), and the Beck Depression Inventory (BDI) and the motor part of the Unified Parkinson Disease Rating Scale (UPDRS-III). The real-rTMS group had improved scores on HRS and the MADRS after 10 sessions, and these beneficial effects persisted for 6 weeks after the initial session. The BDI score did not change immediately after the sessions. The sham-rTMS group had no significant changes in any of the depression rating scales. The UPDRS-III did not change in either group. HF-rTMS of the left DLPFC is an effective treatment for MDD in patients with PD.
重度抑郁症（MDD）在一小部分帕金森病（PD）患者中出现，并降低了他们的生活质量。我们进行了一项随机假对照研究，以评估高频（HF）重复经颅磁刺激（rTMS）左侧背外侧前额叶皮质（DLPFC）对PD患者MDD的影响。10名患者参与了真rTMS组，8名患者参与了假rTMS组。在rTMS治疗后的基线、2周和6周进行评估。所有参与者都接受了抑郁评定量表的检查，包括汉密尔顿评定量表、蒙哥马利-阿斯伯格抑郁评定量表（MADRS）、贝克抑郁量表（BDI）以及统一帕金森病评定量表（UPDRS-III）的运动部分。真rTMS组在10次治疗后HRS和MADRS评分有所改善，且这些有益效果在首次治疗后持续了6周。治疗后BDI评分没有立即变化。假rTMS组在任何抑郁评定量表上均无显著变化。两组的UPDRS-III均无变化。左侧DLPFC的高频rTMS是治疗PD患者MDD的有效方法。
