Antczak Jakub Maria, Poleszczyk Anna, Wichniak Adam, Rakowicz Maria, Parnowski Tadeusz Jerzy
Zakład Neurofizjologii Klinicznej, Instytut Psychiatrii i Neurologii, Warszawa.
II Klinika Psychiatryczna Instytut Psychiatrii i Neurologii w Warszawie.
Psychiatr Pol. 2017 Oct 29;51(5):845-857. doi: 10.12740/PP/68503.
Repetitive transcranial magnetic stimulation (rTMS) improves mood in depression. In this study we investigated whether the depression-related insomnia is modulated by this therapeutic method.
We examined 13 patients (mean age 50.6±13.9; 11 women) with bipolar or unipolar depression. During 20 consecutive days, excluding Saturdays and Sundays, they underwent 20 daily sessions of 10 Hz rTMS over the left dorsolateral prefrontal cortex (DLPFC). Outcome measurement included the Clinical Global Impression (CGI), the 21item Hamilton Depression Rating Scale (HDRS), the Athens Insomnia Scale (AIS) as well as sleep diary and actigraphy.
After rTMS, the CGI and HDRS total score decreased significantly. Also, the insomnia-related items of HDRS improved. The AIS showed trend towards decrease. No significant changes were present in sleep diaries and actigraphy.
The beneficial effect of rTMS on the mood in depression has been confirmed. The rest of the results suggest high frequency rTMS to the left DLPFC does not have strong effects on sleep quality in patients with depression. Additional interventions or modification of the rTMS protocol should be considered to improve insomnia in these patients.
重复经颅磁刺激（rTMS）可改善抑郁症患者的情绪。在本研究中，我们调查了这种治疗方法是否能调节与抑郁症相关的失眠。
我们检查了13例双相或单相抑郁症患者（平均年龄50.6±13.9岁；11名女性）。在连续20天（不包括周六和周日）期间，他们每天接受20次对左侧背外侧前额叶皮质（DLPFC）进行的10Hz rTMS治疗。结果测量包括临床总体印象量表（CGI）、21项汉密尔顿抑郁量表（HDRS）、雅典失眠量表（AIS）以及睡眠日记和活动记录仪。
rTMS治疗后，CGI和HDRS总分显著下降。此外，HDRS中与失眠相关的项目有所改善。AIS呈下降趋势。睡眠日记和活动记录仪未显示出显著变化。
rTMS对抑郁症患者情绪的有益作用已得到证实。其余结果表明，对左侧DLPFC进行高频rTMS对抑郁症患者的睡眠质量没有强烈影响。应考虑采取额外的干预措施或修改rTMS方案，以改善这些患者的失眠症状。
