da Silva Júnior Hercílio Barbosa, Fernandes Marcos Rassi, Souza Ângela Maria Costa
Medicine Faculty, Federal University of Goiás, Goiânia, Brazil.
Dr. Henrique Santillo State Rehabilitation Centre (CRER), Goiânia, Brazil.
J Cent Nerv Syst Dis. 2019 Aug 23;11:1179573519871304. doi: 10.1177/1179573519871304. eCollection 2019.
Poststroke depression (PSD) is a serious psychiatric complication often reported after a stroke. Nearly a third of stroke survivors experience depressive symptoms at some point, affecting their functional recovery and quality of life. In recent years, repetitive transcranial magnetic stimulation (rTMS) has been studied by many researchers and found to be a safe supporting tool for the treatment of PSD.
We aim to evaluate the effects of rTMS on PSD and on the quality of life of poststroke patients.
A prospective clinical case series, performed at CRER Rehabilitation, Brazil, between June 2016 and May 2017. A nonprobabilistic sample (n = 15) was divided into 2 groups (excitatory stimulation in F3, n = 8; inhibitory stimulation in F4, n = 7) and underwent 20 sessions of rTMS. Individuals were assessed according to the 17-item Hamilton Depression Rating Scale (HAM-D17) and World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) questionnaire at 3 different moments: baseline, at the end of the treatment, and in a 1-month follow-up meeting.
Both groups presented a significant change in the score of all WHOQOL-BREF domains and in HAM-D17. In the group that received inhibitory stimulation (F4), score changes were continuous and gradual, comparing the 3 moments. In the excitatory stimulated (F3) group, however, the improvement in scores was more expressive between baseline and the second moment, without significant changes in the follow-up.
The findings of this clinical study suggest that rTMS can be a promising tool, capable of relieving depressive symptoms and helping in the improvement of poststroke patients' quality of life.
卒中后抑郁（PSD）是卒中后常报道的一种严重精神并发症。近三分之一的卒中幸存者在某些时候会出现抑郁症状，影响其功能恢复和生活质量。近年来，重复经颅磁刺激（rTMS）受到许多研究者的研究，并被发现是治疗PSD的一种安全辅助工具。
我们旨在评估rTMS对PSD及卒中后患者生活质量的影响。
这是一项前瞻性临床病例系列研究，于2016年6月至2017年5月在巴西CRER康复中心进行。一个非概率样本（n = 15）被分为两组（F3区兴奋性刺激组，n = 8；F4区抑制性刺激组，n = 7），并接受20次rTMS治疗。在3个不同时间点，即基线、治疗结束时和1个月随访时，根据17项汉密尔顿抑郁量表（HAM-D17）和世界卫生组织生活质量简表（WHOQOL-BREF）问卷对个体进行评估。
两组在所有WHOQOL-BREF领域得分及HAM-D17得分均有显著变化。在接受抑制性刺激（F4）的组中，比较3个时间点，得分变化是持续且逐渐的。然而，在兴奋性刺激（F3）组中，基线与第二个时间点之间得分改善更明显，随访时无显著变化。
这项临床研究结果表明，rTMS可能是一种有前景的工具，能够缓解抑郁症状并有助于改善卒中后患者的生活质量。
