Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany.
Department of Psychology, Clinical Psychology & Psychotherapy, University of Tübingen, Schleichstr. 4, 72076 Tübingen, Germany.
Prog Neuropsychopharmacol Biol Psychiatry. 2019 Jun 8;92:285-300. doi: 10.1016/j.pnpbp.2019.01.014. Epub 2019 Jan 29.
Repetitive Transcranial Magnetic Stimulation (rTMS) is a neuromodulatory treatment intervention, which can be used to alleviate symptoms of mental disorders. Theta-burst stimulation (TBS), an advanced, patterned form of TMS, features several advantages regarding applicability, treatment duration and neuroplastic effects. This clinical review summarizes TBS studies in mental disorders and tinnitus and discusses effectivity and future directions of clinical TBS research. Following the PRISMA guidelines, the authors included 47 studies published until July 2018. Particularly in depression, evidence for the effectiveness of TBS and non-inferiority to conventional rTMS exists. Evidence for therapeutic efficacy of TBS in other mental disorders remains weak due to a large heterogeneity between studies. Rigorous reporting standards and adequately powered controlled trials are indispensable to foster validity and translation into clinical use. Nevertheless, TBS remains a promising instrument to target maladaptive brain networks and to ameliorate psychiatric symptoms.
重复经颅磁刺激(rTMS)是一种神经调节治疗干预措施,可用于缓解精神障碍的症状。θ爆发刺激(TBS)是 TMS 的一种高级、有模式的形式,在适用性、治疗持续时间和神经可塑性方面具有几个优势。本临床综述总结了 TBS 在精神障碍和耳鸣中的研究,并讨论了临床 TBS 研究的有效性和未来方向。作者按照 PRISMA 指南,纳入了截至 2018 年 7 月发表的 47 项研究。特别是在抑郁症中,TBS 的有效性和对常规 rTMS 的非劣效性存在证据。由于研究之间存在很大的异质性,TBS 在其他精神障碍中的治疗效果证据仍然薄弱。严格的报告标准和充分有力的对照试验对于提高有效性并将其转化为临床应用是不可或缺的。尽管如此,TBS 仍然是一种有前途的工具,可以针对适应不良的大脑网络并改善精神症状。