Alhelali Abdullah, Almheiri Eisa, Abdelnaim Mohamed, Weber Franziska C, Langguth Berthold, Schecklmann Martin, Hebel Tobias
Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany.
Brain Sci. 2022 Feb 23;12(3):298. doi: 10.3390/brainsci12030298.
Repetitive transcranial magnetic stimulation (rTMS) is effective in the treatment of depression. However, for the subset of patients with bipolar disorder, less data is available and overall strength of evidence is weaker than for its use in unipolar depression. A cohort of 505 patients (of which 46 had a diagnosis of bipolar disorder) with depression who were treated with rTMS were analyzed retrospectively with regards to their response to several weeks of treatment. Hamilton Depression Rating Scale (HDRS) was assessed as main outcome. Unipolar and bipolar patients with depression did not differ significantly in baseline demographic variables or severity of depression. Both groups did not differ significantly in their response to treatment as indicated by absolute and relative changes in the HDRS and response and remission rates. On HDRS subitem-analysis, bipolar patients showed superior amelioration of the symptom "paranoid symptoms" in a statistically significant manner. In conclusion, depressed patients with a diagnosis of bipolar disorder benefit from rTMS in a similar fashion as patients with unipolar depression in a naturalistic setting. rTMS might be more effective in reducing paranoia in bipolar than in unipolar patients.
重复经颅磁刺激（rTMS）在抑郁症治疗中有效。然而，对于双相情感障碍患者亚组，可用数据较少，且证据的总体强度弱于其在单相抑郁症中的应用。对一组接受rTMS治疗的505例抑郁症患者（其中46例诊断为双相情感障碍）进行回顾性分析，观察他们对数周治疗的反应。以汉密尔顿抑郁量表（HDRS）作为主要结局指标进行评估。单相和双相抑郁症患者在基线人口统计学变量或抑郁严重程度方面无显著差异。根据HDRS的绝对和相对变化以及反应率和缓解率，两组在治疗反应方面无显著差异。在HDRS子项目分析中，双相情感障碍患者在“偏执症状”这一症状上有统计学意义的更明显改善。总之，诊断为双相情感障碍的抑郁症患者在自然环境中与单相抑郁症患者一样，能从rTMS中获益。rTMS在减轻双相情感障碍患者的偏执症状方面可能比单相抑郁症患者更有效。
