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治疗抵抗性抑郁症的新神经调节技术。

New neuromodulation techniques for treatment resistant depression.

机构信息

Psychiatry Department, CHHM, Hospital Andre Breton, Saint-Dizier, France.

Department of Neurosurgery, Hospital Pitié Salpêtrière, Paris, France.

出版信息

Int J Psychiatry Clin Pract. 2020 Jun;24(2):106-115. doi: 10.1080/13651501.2020.1728340. Epub 2020 Feb 18.

Abstract

In the treatment of depression, when pharmacotherapy, psychotherapy and the oldest brain stimulation techniques are deadlocked, the emergence of new therapies is a necessary development. The field of neuromodulation is very broad and controversial. This article provides an overview of current progress in the technological advances in neuromodulation and neurostimulation treatments for treatment-resistant depression: magnetic seizure therapy; focal electrically administered seizure therapy; low field magnetic stimulation; transcranial pulsed electromagnetic fields; transcranial direct current stimulation; epidural cortical stimulation; trigeminal nerve stimulation; transcutaneous vagus nerve stimulation; transcranial focussed ultrasound; near infra-red transcranial radiation; closed loop stimulation. The role of new interventions is expanding, probably with more efficacy. Nowadays, still under experimentation, neuromodulation will probably revolutionise the field of neuroscience. At present, major efforts are still necessary before that these therapies are likely to become widespread.Key pointsThere is a critical need for new therapies for treatment resistant depression.Newer therapies are expanding. In the future, these therapies, as an evidence-based adjunctive treatments, could offer a good therapeutic choice for the patients with a TRD.The current trend in the new neuromodulation therapies is to apply a personalised treatment.These news therapies can be complementary.That treatment approaches can provide clinically significant benefits.

摘要

在抑郁症的治疗中,当药物治疗、心理治疗和最古老的脑刺激技术陷入僵局时,新疗法的出现是必要的发展。神经调节领域非常广泛且存在争议。本文概述了治疗抵抗性抑郁症的神经调节和神经刺激治疗技术的最新进展:磁惊厥治疗;局灶性电惊厥治疗;低场磁刺激;经颅脉冲电磁场;经颅直流电刺激;硬膜外皮层刺激;三叉神经刺激;经皮迷走神经刺激;经颅聚焦超声;近红外经颅辐射;闭环刺激。新干预措施的作用正在扩大,可能更有效。如今,神经调节仍在实验中,可能会彻底改变神经科学领域。目前,在这些疗法广泛应用之前,仍需要进行大量的研究工作。

关键点

治疗抵抗性抑郁症需要新的治疗方法。

更新的疗法正在不断扩展。在未来,这些疗法作为一种基于证据的辅助治疗方法,可能为 TRD 患者提供一种很好的治疗选择。

新的神经调节疗法的当前趋势是采用个性化治疗。

这些新疗法可以互补。

治疗方法可以提供有临床意义的益处。

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