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精神障碍重复经颅磁刺激临床应用的更新综述。

Updated Review on the Clinical Use of Repetitive Transcranial Magnetic Stimulation in Psychiatric Disorders.

机构信息

Shanghai Key Laboratory of Psychotic Disorders (No. 13dz2260500), Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.

Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, 200030, China.

出版信息

Neurosci Bull. 2017 Dec;33(6):747-756. doi: 10.1007/s12264-017-0185-3. Epub 2017 Oct 24.

Abstract

With the ability to modulate cortical activity, repetitive transcranial magnetic stimulation (rTMS) is becoming increasingly important in clinical applications for psychiatric disorders. Previous studies have demonstrated its promising efficacy in depression and schizophrenia, and emerging evidence has also been found in patients with anxiety disorder, obsessive-compulsive disorder, and substance or food craving. However, the overall literature features some conflicting results, varied quality of studies, and a lack of consensus on optimal rTMS parameters. Besides, the efficacy of rTMS in patients with medication-resistant symptoms has drawn most attention from clinicians. Here we review multi-site studies and double-blind randomized controlled trials (RCTs) in single sites, as well as meta-analyses of RCTs in the last three years, in order to update evidence on efficacy and the optimal protocol of rTMS in psychiatric disorders, especially for medication-resistant symptoms.

摘要

经颅重复磁刺激(rTMS)具有调节皮质活动的能力,在精神疾病的临床应用中变得越来越重要。先前的研究表明,rTMS 在抑郁症和精神分裂症方面有很好的疗效,而且在焦虑症、强迫症、物质或食物成瘾的患者中也有新的证据。然而,总体文献存在一些相互矛盾的结果,研究质量参差不齐,并且 rTMS 参数的最佳选择尚未达成共识。此外,rTMS 在药物难治性症状患者中的疗效引起了临床医生的极大关注。在这里,我们回顾了多中心研究和单中心的双盲随机对照试验(RCT),以及过去三年的 RCT 的荟萃分析,以更新 rTMS 在精神疾病中的疗效和最佳方案的证据,特别是针对药物难治性症状。

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