Carrico Whitney T, Georgette Gerald, Madore Michelle R, Kozel F Andrew, George Mark S, Lindley Steven, Lovett Steven, Yoon Jong H, Yesavage Jerome A
is a Fellow in the Veterans Affairs (VA) War Related Injury and Illness Study Center; is a Clinical Research Nurse Coordinator; is Director of the VA National Clinical Repetitive Transcranial Magnetic Stimulation (TMS) Pilot Program; is an Attending Psychiatrist and Director of the Neuromodulation Clinic; is Director, Outpatient Mental Health; is Chief, Psychology Service; and is an Associate Chief of Staff for Mental Health and Director of the Mental Illness Education, Research and Clinical Centers; all at VA Palo Alto Health Care System in California. is Director of the TMS Clinic and a Staff Psychiatrist at James A. Haley Veterans Hospital; and a Professor, University of South Florida in Tampa. is a Distinguished University Professor of Psychiatry, Neurology and Radiology and Director of the Brain Stimulation Division, Medical University of South Carolina, and a Staff Psychiatrist and Director of the TMS Clinic at Ralph H. Johnson VA Medical Center in Charleston. Steven Lindley and Jong Yoon are Associate Professors of Psychiatry; and Jerome Yesavage is an Associate Chair of Psychiatry and Behavioral Sciences and Professor of Neurology and Neurological Sciences (by courtesy); all at Stanford University School of Medicine in Palo Alto.
Fed Pract. 2020 Jun;37(6):276-281.
Repetitive transcranial magnetic stimulation (rTMS) uses a device to create magnetic fields that cause electrical current to flow into targeted neurons in the brain. The most common clinical use of rTMS is for the treatment of major depressive disorder (MDD). The annual suicide rate of veterans has been higher than the national average; treating depression with rTMS would likely decrease suicide risk. MDD in many patients can be chronic and reoccurring with medication and psychotherapy providing inadequate relief.
A pilot program was created to supply rTMS devices to 35 different sites in the VA nationwide in order to treat treatment-resistant depression.
At time of analysis more than 950 veterans have started the program and 412 have finished. Nationwide, we have seen the depression scores decline, indicating an improvement in well-being. In addition, there is high patient satisfaction. Collecting data on a national level is a powerful way to examine rTMS efficacy and predictors of response which might be lost on a smaller subset of cases.
重复经颅磁刺激（rTMS）使用一种设备来产生磁场，从而使电流流入大脑中的目标神经元。rTMS最常见的临床用途是治疗重度抑郁症（MDD）。退伍军人的年自杀率一直高于全国平均水平；用rTMS治疗抑郁症可能会降低自杀风险。许多患者的MDD可能是慢性且复发的，药物治疗和心理治疗提供的缓解效果不足。
创建了一个试点项目，向全国退伍军人事务部（VA）的35个不同地点提供rTMS设备，以治疗难治性抑郁症。
在分析时，超过950名退伍军人已开始该项目，412人已完成。在全国范围内，我们看到抑郁评分下降，表明幸福感有所改善。此外，患者满意度很高。在国家层面收集数据是检验rTMS疗效和反应预测因素的有力方法，而这些因素在较小的病例子集中可能会丢失。
