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经颅磁刺激和直流电刺激治疗抑郁症:介入性精神病学中两种常用脑刺激方法的基本机制和挑战。

Transcranial Magnetic and Direct Current Stimulation in the Treatment of Depression: Basic Mechanisms and Challenges of Two Commonly Used Brain Stimulation Methods in Interventional Psychiatry.

机构信息

Laboratory of Systems Neuroscience and Imaging in Psychiatry (SNIP-Lab), Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.

Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany,

出版信息

Neuropsychobiology. 2020;79(6):397-407. doi: 10.1159/000502149. Epub 2019 Sep 5.

Abstract

Noninvasive neuromodulation, including repetitive trans-cranial magnetic stimulation (rTMS) and direct current stimulation (tDCS), provides researchers and health care professionals with the ability to gain unique insights into brain functions and treat several neurological and psychiatric conditions. Undeniably, the number of published research and clinical papers on this topic is increasing exponentially. In parallel, several methodological and scientific caveats have emerged in the transcranial stimulation field; these include less robust and reliable effects as well as contradictory clinical findings. These inconsistencies are maybe due to the fact that research exploring the relationship between the methodological aspects and clinical efficacy of rTMS and tDCS is far from conclusive. Hence, additional work is needed to understand the mechanisms underlying the effects of magnetic stimulation and low-intensity transcranial electrical stimulation (TES) in order to optimize dosing, methodological designs, and safety aspects.

摘要

非侵入性神经调节,包括重复经颅磁刺激(rTMS)和经颅直流电刺激(tDCS),为研究人员和医疗保健专业人员提供了独特的洞察大脑功能的能力,并治疗多种神经和精神疾病。不可否认,关于这个主题的已发表的研究和临床论文的数量正在呈指数级增长。与此同时,经颅刺激领域也出现了一些方法学和科学上的警告;这些警告包括效果不那么稳健和可靠,以及临床发现相互矛盾。这些不一致可能是由于研究探索 rTMS 和 tDCS 的方法学方面与临床疗效之间的关系的工作还远远没有得出结论。因此,需要做更多的工作来理解磁场刺激和低强度经颅电刺激(TES)的作用机制,以优化剂量、方法学设计和安全方面。

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