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针对颞顶联合区评估和治疗离体现象:对经颅磁刺激(TMS)对人格解体和现实解体障碍(DPD)及身体错觉影响的系统评价

Targeting temporal parietal junction for assessing and treating disembodiment phenomena: a systematic review of TMS effect on depersonalization and derealization disorders (DPD) and body illusions.

作者信息

Orrù Graziella, Bertelloni Davide, Cesari Valentina, Conversano Ciro, Gemignani Angelo

机构信息

Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine University of Pisa, via Savi, 10, 56126, Pisa, Italy.

出版信息

AIMS Neurosci. 2021 Jan 12;8(2):181-194. doi: 10.3934/Neuroscience.2021009. eCollection 2021.

Abstract

The temporal-parietal junction (TPJ) is a key structure for the embodiment, term referred to as the sense of being localized within one's physical body and is a fundamental aspect of the self. On the contrary, the sense of disembodiment, an alteration of one's sense of self or the sense of being localized out of one's physical body, is a prominent feature in specific dissociative disorders, namely depersonalization/derealization disorders (DPD). The aims of the study were to provide: 1) a qualitative synthesis of the effect of Transcranial Magnetic Stimulation (TMS), taking into account its use for therapeutic and experimental purposes; 2) a better understanding on whether the use of TMS could support the treatment of DPD and other clinical conditions in which depersonalization and derealization are displayed. To identify suitable publications, an online search of the PubMed, Cochrane Library, Web of science and Scopus databases was performed using relevant search terms. In addition, an in-depth search was performed by screening review articles and the references section of each included articles. Our search yielded a total of 108 records through multiple databases searching and one additional record was identified through other sources. After duplicates removal, title and abstract reading, we retained 16 records for the assessment of eligibility. According to our inclusion criteria, we retained 8 studies. The selected studies showed that TMS targeting the TPJ is a promising technique for treating disembodiment phenomena DPD and for inducing reversible disembodiment states in healthy subjects. These data represent the first step towards a greater understanding of possible treatments to be used in disembodiment disorders. The use of TMS over the TPJ appears to be promising for treating disembodiment phenomena.

摘要

颞顶联合区(TPJ)是体现身体存在感(即身体定位感)的关键结构,是自我意识的一个基本方面。相反,离体感,即自我意识或身体定位感的改变,是特定解离性障碍(即人格解体/现实解体障碍,DPD)的一个突出特征。本研究的目的是:1)对经颅磁刺激(TMS)的效果进行定性综合分析,同时考虑其在治疗和实验中的应用;2)更好地了解TMS的使用是否有助于治疗DPD以及其他表现出人格解体和现实解体的临床病症。为了识别合适的出版物,我们使用相关搜索词在PubMed、Cochrane图书馆、科学网和Scopus数据库中进行了在线搜索。此外,通过筛选综述文章和每篇纳入文章的参考文献部分进行了深入搜索。通过多个数据库搜索,我们共获得108条记录,通过其他来源又识别出1条记录。在去除重复项、阅读标题和摘要后,我们保留了16条记录进行资格评估。根据我们的纳入标准,我们保留了8项研究。所选研究表明,针对TPJ的TMS是治疗离体现象(DPD)以及在健康受试者中诱导可逆离体状态的一种有前景的技术。这些数据代表了朝着更好地理解可用于治疗离体障碍的可能治疗方法迈出的第一步。在TPJ上使用TMS似乎有望治疗离体现象。

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