Kinfe Thomas M, Hurlemann René
Abteilung für Medizinische Psychologie, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland.
Nervenarzt. 2019 Jan;90(1):73-88. doi: 10.1007/s00115-018-0640-z.
Given that one third of patients with schizophrenia (SZ) only show limited response to established treatments, alternative therapeutic strategies such as non-invasive/invasive brain stimulation approaches have emerged as an adjunctive treatment option for distinct SZ symptom domains (e.g. acoustic hallucinations, negative/positive symptoms and cognitive impairment). Taking comparative interventional studies and standardized technical parameters into consideration, current meta-analyses indicate that adjunctive electroconvulsive therapy, repetitive transcranial magnetic stimulation and transcranial direct current stimulation have a positive effect. Invasive deep brain stimulation and MR-guided ultrasound brain ablation procedures represent treatment modalities that are currently being clinically tested. Complementary pre-interventional screening approaches (e.g. electrophysiology, neuroimaging and molecular inflammatory profiling) have been recommended in order to identify symptom-tailored predictive measures for diagnosis and treatment.
鉴于三分之一的精神分裂症(SZ)患者对现有治疗仅表现出有限的反应,诸如非侵入性/侵入性脑刺激方法等替代治疗策略已成为针对不同SZ症状领域(如幻听、阴性/阳性症状和认知障碍)的辅助治疗选择。考虑到比较性干预研究和标准化技术参数,目前的荟萃分析表明,辅助性电休克治疗、重复经颅磁刺激和经颅直流电刺激具有积极效果。侵入性深部脑刺激和磁共振引导超声脑消融手术是目前正在进行临床试验的治疗方式。为了确定针对诊断和治疗的症状特异性预测指标,已推荐采用补充性干预前筛查方法(如电生理学、神经影像学和分子炎症分析)。