Kobayashi Brian, Cook Ian A, Hunter Aimee M, Minzenberg Michael J, Krantz David E, Leuchter Andrew F
a David Geffen School of Medicine , University of California Los Angeles , Los Angeles , CA , USA.
b Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine , University of California Los Angeles , Los Angeles , CA , USA.
Int Rev Psychiatry. 2017 Apr;29(2):98-114. doi: 10.1080/09540261.2017.1297697. Epub 2017 Mar 31.
Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for Major Depressive Disorder (MDD). There are clinical data that support the efficacy of many different approaches to rTMS treatment, and it remains unclear what combination of stimulation parameters is optimal to relieve depressive symptoms. Because of the costs and complexity of studies that would be necessary to explore and compare the large number of combinations of rTMS treatment parameters, it would be useful to establish reliable surrogate biomarkers of treatment efficacy that could be used to compare different approaches to treatment. This study reviews the evidence that neurophysiologic measures of cortical excitability could be used as biomarkers for screening different rTMS treatment paradigms. It examines evidence that: (1) changes in excitability are related to the mechanism of action of rTMS; (2) rTMS has consistent effects on measures of excitability that could constitute reliable biomarkers; and (3) changes in excitability are related to the outcomes of rTMS treatment of MDD. An increasing body of evidence indicates that these neurophysiologic measures have the potential to serve as reliable biomarkers for screening different approaches to rTMS treatment of MDD.
重复经颅磁刺激（rTMS）是治疗重度抑郁症（MDD）的一种有效方法。有临床数据支持多种不同rTMS治疗方法的疗效，但尚不清楚哪种刺激参数组合最能有效缓解抑郁症状。由于探索和比较大量rTMS治疗参数组合所需的研究成本高且复杂，因此建立可靠的治疗疗效替代生物标志物以比较不同治疗方法将很有帮助。本研究回顾了皮质兴奋性的神经生理学测量可作为筛选不同rTMS治疗方案生物标志物的证据。它审视了以下证据：（1）兴奋性变化与rTMS的作用机制有关；（2）rTMS对可构成可靠生物标志物的兴奋性测量有一致影响；（3）兴奋性变化与MDD的rTMS治疗结果有关。越来越多的证据表明，这些神经生理学测量有可能作为筛选MDD的不同rTMS治疗方法的可靠生物标志物。
