Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Neurology, Harvard Medical School, Boston, Massachusetts.
Biol Psychiatry. 2024 Mar 15;95(6):502-509. doi: 10.1016/j.biopsych.2023.11.011. Epub 2023 Nov 17.
Increasing evidence suggests that the clinical effects of transcranial magnetic stimulation are target dependent. Within any given symptom, precise targeting of specific brain circuits may improve clinical outcomes. This principle can also be extended across symptoms-stimulation of different circuits may lead to different symptom-level outcomes. This may include targeting different symptoms within the same disorder (such as dysphoria vs. anxiety in patients with major depression) or targeting the same symptom across different disorders (such as primary major depression and depression secondary to stroke, traumatic brain injury, epilepsy, multiple sclerosis, or Parkinson's disease). Some of these symptom-specific changes may be desirable, while others may be undesirable. This review focuses on the conceptual framework through which symptom-specific target circuits may be identified, tested, and implemented.
越来越多的证据表明，经颅磁刺激的临床效果是与目标相关的。在任何给定的症状中，对特定脑回路的精确靶向可能会改善临床结果。这一原则也可以扩展到症状上——刺激不同的回路可能会导致不同的症状水平结果。这可能包括针对同一疾病中的不同症状（例如，重度抑郁症患者的抑郁和焦虑），或针对不同疾病中的相同症状（例如，原发性重度抑郁症和中风、脑外伤、癫痫、多发性硬化症或帕金森病引起的继发性抑郁症）。其中一些针对症状的改变可能是可取的，而另一些则可能是不可取的。本综述重点介绍了识别、测试和实施针对症状的目标回路的概念框架。
