Kumar Saurabh, Singh Swarndeep, Kumar Nand, Verma Rohit
Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
Clin Psychopharmacol Neurosci. 2018 Feb 28;16(1):62-66. doi: 10.9758/cpn.2018.16.1.62.
The literature on managing migraine non-responsive to pharmacological approaches and that co-occurring with depression is scanty. The comorbid condition predicts a poorer prognosis for migraine as well as depression. The present report assesses efficacy and tolerability of high frequency repetitive transcranial magnetic stimulation (rTMS) over left dorsolateral prefrontal cortex as a treatment modality for migraine with comorbid depression.
The current retrospective chart review assesses effectiveness of high frequency rTMS over left dorsolateral prefrontal cortex as a treatment modality to manage migraine occurring comorbid with depression in 14 subjects.
The mean scores on Migraine Disability Assessment Test (MIDAS) and depression rating scale reduced significantly from 21.14±3.01 and 20.71±3.95 at baseline to 13.93±6.09 and 14.21±5.52 respectively, after rTMS. There was significant improvement in migraine frequency, severity and functional disability assessed using MIDAS scores (＜0.05) following high frequency rTMS compared to baseline.
There is a role of applying rTMS as a potential therapeutic modality in the integrated management of a distinct subgroup of migraine patients with comorbid depression.
关于对药物治疗无反应且合并抑郁症的偏头痛的文献较少。这种共病情况预示着偏头痛和抑郁症的预后较差。本报告评估高频重复经颅磁刺激（rTMS）作用于左侧背外侧前额叶皮质作为合并抑郁症的偏头痛治疗方式的疗效和耐受性。
当前的回顾性病历审查评估了高频rTMS作用于左侧背外侧前额叶皮质作为治疗方式对14例合并抑郁症的偏头痛患者的有效性。
经rTMS治疗后，偏头痛残疾评估测试（MIDAS）和抑郁评定量表的平均得分分别从基线时的21.14±3.01和20.71±3.95显著降至13.93±6.09和14.21±5.52。与基线相比，使用MIDAS评分评估，高频rTMS后偏头痛频率、严重程度和功能残疾有显著改善（＜0.05）。
在合并抑郁症的偏头痛患者这一特定亚组的综合管理中，应用rTMS作为一种潜在治疗方式具有一定作用。
