Lonergan Brady, Nguyen Eliza, Lembo Cara, Hinchman Carrie, Morales Oscar G, Press Daniel Z, Pascual-Leone Alvaro, Stern Adam P
From the Department of Psychiatry, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston (BL, APS); the Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston (EN, CL, CH, DZP, AP-L, APS); and McLean Hospital, Belmont, Mass. (OGM).
J Neuropsychiatry Clin Neurosci. 2018 Summer;30(3):242-245. doi: 10.1176/appi.neuropsych.17070146. Epub 2018 Jan 25.
Four transcranial magnetic stimulation (TMS) devices are currently approved for use in treatment-resistant depression. The authors present the first data-driven study examining the patient- and technician-experience using three of these distinct devices. A retrospective survey design with both patient and technician arms was utilized. The study population included patients who received TMS for treatment-resistant depression at the Berenson Allen Center for Noninvasive Brain Stimulation for the first time between 2013 and 2016 and technicians who worked in the program from 2009 to 2017. Statistical analysis included t tests and analyses of variance to assess differences between and across the multiple groups, respectively. Patients treated with the NeuroStar device reported greater confidence that the treatment was being performed correctly compared with those treated with the Magstim device. Conversely, with regard to tolerability, patients treated with the Magstim device reported less pain in the last week and less pain on average compared with those treated with the NeuroStar device. On average, technicians reported feeling that both the Magstim and NeuroStar devices were significantly easier to use than the Brainsway Deep TMS H-Coil device. Additionally, they found the former two devices to be more reliable and better tolerated. Furthermore, the technicians reported greater confidence in the Magstim and NeuroStar devices compared with the Brainsway Deep TMS H-Coil device and indicated that they would be more likely to recommend the two former devices to other treatment centers.
目前有四种经颅磁刺激(TMS)设备被批准用于治疗难治性抑郁症。作者开展了第一项数据驱动的研究,对其中三种不同设备的患者体验和技术人员体验进行了考察。采用了包含患者和技术人员两组的回顾性调查设计。研究人群包括2013年至2016年间首次在贝伦森·艾伦无创脑刺激中心接受TMS治疗难治性抑郁症的患者,以及2009年至2017年在该项目工作的技术人员。统计分析包括t检验和方差分析,分别用于评估多组之间以及多组内部的差异。与使用Magstim设备治疗的患者相比,使用NeuroStar设备治疗的患者对治疗操作正确与否更有信心。相反,在耐受性方面,与使用NeuroStar设备治疗的患者相比,使用Magstim设备治疗的患者在上周疼痛更少,平均疼痛程度也更低。平均而言,技术人员表示,他们觉得Magstim和NeuroStar设备比Brainsway深部TMS H型线圈设备明显更容易操作。此外,他们发现前两种设备更可靠,耐受性更好。此外,与Brainsway深部TMS H型线圈设备相比,技术人员对Magstim和NeuroStar设备更有信心,并表示他们更有可能向其他治疗中心推荐前两种设备。