Ozer Ufuk, Yucens Bengu, Tumkaya Selim
Pamukkale University, Department of Psychiatry, Kınıklı, Denizli, Turkey.
Pamukkale University, Department of Psychiatry, Kınıklı, Denizli, Turkey.
J Psychiatr Res. 2024 Mar;171:325-331. doi: 10.1016/j.jpsychires.2024.02.005. Epub 2024 Feb 2.
High-frequency deep transcranial magnetic stimulation (dTMS) targeting the medial prefrontal cortex (mPFC) and the anterior cingulate cortex (ACC) with an H-coil has received approval from the Food and Drug Administration for the treatment of obsessive-compulsive disorder (OCD). Nevertheless, there is limited evidence regarding the efficacy of a similar procedure performed using a double-cone coil or in an accelerated regimen. In this study, patients in the active TMS group (n = 14) underwent stimulation of the mPFC and ACC twice daily at a frequency of 20 Hz for three weeks, using a double-cone coil. The same procedure was applied to the control group (n = 15) using a placebo coil. Throughout the study, the patients continued their antidepressant and/or antipsychotic treatments at the same dose. Following treatment, the active TMS group exhibited a more significant reduction in Yale-Brown Obsessive-Compulsive Scale scores (pre-treatment: 25.36 ± 5.4, post-treatment: 18.43 ± 6.86) and Hamilton Anxiety Rating Scale scores (pre-treatment: 10.6 ± 3.5, post-treatment: 6.7 ± 2.7) compared to the sham TMS group. However, there was no statistically significant reduction in symmetry-related obsessive-compulsive symptoms in the TMS group compared to the sham TMS group. dTMS applied to the mPFC and ACC, using a double-cone coil at a 20-Hz frequency twice daily for three weeks, was found to be effective as an adjunctive treatment for treatment-resistant OCD.
使用H型线圈靶向内侧前额叶皮质(mPFC)和前扣带回皮质(ACC)的高频深部经颅磁刺激(dTMS)已获得美国食品药品监督管理局批准用于治疗强迫症(OCD)。然而,关于使用双锥线圈或加速治疗方案进行类似治疗的疗效证据有限。在本研究中,主动经颅磁刺激组(n = 14)的患者使用双锥线圈,每天两次,以20赫兹的频率刺激mPFC和ACC,持续三周。对照组(n = 15)使用安慰剂线圈进行相同的操作。在整个研究过程中,患者继续以相同剂量进行抗抑郁和/或抗精神病治疗。治疗后,与假经颅磁刺激组相比,主动经颅磁刺激组在耶鲁-布朗强迫症量表评分(治疗前:25.36±5.4,治疗后:18.43±6.86)和汉密尔顿焦虑量表评分(治疗前:10.6±3.5,治疗后:6.7±2.7)上有更显著的降低。然而,与假经颅磁刺激组相比,经颅磁刺激组在对称性相关强迫症症状方面没有统计学上的显著降低。每天两次,以20赫兹的频率使用双锥线圈对mPFC和ACC进行经颅磁刺激三周,被发现作为难治性强迫症的辅助治疗是有效的。