Bröcker Erine, van den Heuvel Leigh, Seedat Soraya
Department of Psychiatry, Faculty of Medical Health Sciences, Stellenbosch University, Cape Town, South Africa.
S Afr J Psychiatr. 2019 Nov 27;25(0):1346. doi: 10.4102/sajpsychiatry.v25i0.1346. eCollection 2019.
This case series documents local experience using accelerated theta-burst repetitive transcranial magnetic stimulation (rTMS) as a supplementary treatment for depression in both major depressive disorder (MDD) and bipolar disorder (BD). Nine consenting patients (MDD = 7; BD = 2) each received 20 accelerated theta-burst sessions over 8 days. Improvement was monitored using the Centre for Epidemiological Studies Depression (CES-D) Scale and the Clinical Global Impression (CGI) Scale at baseline, at day 5 and at day 8 of rTMS treatment. We performed a Wilcoxon matched-pairs signed-rank test to determine whether there was a difference in scores from baseline to post-treatment. The CES-D scores decreased significantly from baseline to post-treatment ( = -2.547, = 0.011) with five patients experiencing at least a 50% symptom reduction on the CES-D. CGI severity scores also decreased significantly between baseline and post-treatment ( = -2.547, = 0.011). The most commonly reported adverse effect was mild headaches, lasting a few hours during and after rTMS treatment. The findings suggest that the accelerated theta-burst rTMS protocol for depression is well tolerated with most patients also experiencing symptomatic improvement by day 8.
本病例系列记录了使用加速θ波爆发重复经颅磁刺激（rTMS）作为重度抑郁症（MDD）和双相情感障碍（BD）抑郁补充治疗的本地经验。9名同意参与的患者（MDD = 7；BD = 2）每人在8天内接受20次加速θ波爆发放电治疗。在rTMS治疗的基线、第5天和第8天，使用流行病学研究中心抑郁量表（CES-D）和临床总体印象量表（CGI）监测改善情况。我们进行了Wilcoxon配对符号秩检验，以确定从基线到治疗后分数是否存在差异。CES-D分数从基线到治疗后显著降低（ = -2.547， = 0.011），5名患者的CES-D症状至少减轻了50%。CGI严重程度分数在基线和治疗后之间也显著降低（ = -2.547， = 0.011）。最常报告的不良反应是轻度头痛，在rTMS治疗期间和之后持续数小时。研究结果表明，用于治疗抑郁症的加速θ波爆发rTMS方案耐受性良好，大多数患者在第8天也有症状改善。
