Chalah Moussa A, Ayache Samar S
Service de Physiologie, Explorations Fonctionnelles, Hôpital Henri-Mondor, AP-HP, 94010 Créteil, France.
EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, 94010 Créteil, France.
Brain Sci. 2019 Apr 14;9(4):82. doi: 10.3390/brainsci9040082.
Among the most prevalent psychiatric conditions stand anxiety and depression. Psychotherapy and medications are considered effective treatments in these clinical settings. However, pharmacotherapy and psychotherapy (i.e., cognitive behavioral therapy (CBT)) administered in monotherapy or in a combined regimen do not result in satisfactory outcomes in all patients. Therefore, finding new treatments would be of great help. In the last three decades, noninvasive brain stimulation (NIBS) has emerged as a safe tool to improve several neuropsychiatric symptoms. The following work revisits the available reports that assessed the add-on value of NIBS techniques when combined to psychotherapy (CBT or related interventions) in mood and anxiety disorders. The available protocols targeted the prefrontal cortex, a region that was previously found to have an enhanced activity or functional connectivity after psychotherapeutic interventions. Promising yet scarce evidence exists on this matter. A discrepancy exists among the available reports regarding the type and duration of interventions, the patients' clinical profiles, and the presence of a sham intervention. NIBS may have acted by enhancing psychotherapy effects on the top-down cognitive control of emotions. Combining both therapies may result in promising effects, but future large-scale trials are needed to judge the utility of this combination in psychiatric populations.
焦虑和抑郁是最常见的精神疾病。在这些临床环境中，心理治疗和药物治疗被认为是有效的治疗方法。然而，单独使用药物治疗或心理治疗（即认知行为疗法（CBT））或联合使用这两种疗法，并非对所有患者都能产生令人满意的效果。因此，寻找新的治疗方法将大有帮助。在过去三十年中，无创脑刺激（NIBS）已成为一种改善多种神经精神症状的安全工具。以下工作回顾了现有报告，这些报告评估了NIBS技术与心理治疗（CBT或相关干预）联合用于治疗情绪和焦虑障碍时的附加价值。现有方案针对前额叶皮层，该区域先前被发现经过心理治疗干预后活动增强或功能连接增强。关于此事有一些有前景但稀少的证据。现有报告在干预类型和持续时间、患者临床特征以及是否存在假干预方面存在差异。NIBS可能通过增强心理治疗对情绪自上而下认知控制的作用来发挥作用。将两种疗法结合可能会产生有前景的效果，但需要未来的大规模试验来判断这种联合疗法在精神疾病患者中的效用。
