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低频重复经颅磁刺激治疗强迫症后视网膜撕裂。

Retinal Tear Following Low-Frequency Repetitive Transcranial Magnetic Stimulation for Obsessive-Compulsive Disorder.

机构信息

Gulhane Training and Research Hospital, Department of Psychiatry, Ankara, Turkey.

Gulhane Training and Research Hospital, Department of Ophthalmology, Ankara, Turkey.

出版信息

Clin Neuropharmacol. 2024;47(3):101-103. doi: 10.1097/WNF.0000000000000589.

Abstract

OBJECTIVES

Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive form of brain stimulation that uses magnetic pulses to stimulate specific brain regions. Retina is being investigated whether the retina, which is also known as the brain's window to the outside world, is affected by the treatment.

METHODS

Magventure X100 device was used for the procedure. The bilateral supplementary motor area was targeted. Procedure protocol: power: 47%, repetitive rate (frequency): 1 Hz, pulses in train duration: 300, intertrain interval (waiting time): 120 seconds, number of trains: 4, total pulses: 1200. Twenty sessions of rTMS were planned for the patient. The patient was informed about the procedure, and her consent was obtained.

RESULTS

The Yale-Brown Obsessive-Compulsive Disorder Scale (YBOCS) score before the first session was 31, and the Brown Assessment Beliefs Scale (BABS) score was 5. The patient's YBOCS score after the 15th session was 14, and the BABS score was 0. After the implementation of the 15th session of the patient's treatment, retinal detachment developed in the right eye, and the treatment was terminated. As a result of the eye examination of the patient, it was determined that there was 1 horseshoe rupture and 2 hole-shaped ruptures in the lower half of the left eye.

CONCLUSIONS

Patients at risk for retinal detachment may require specialized treatment and close monitoring to prevent the condition from worsening. It is important to consult with an ophthalmologist for patients at risk for retinal detachment before TMS application.

摘要

目的

重复经颅磁刺激(rTMS)是一种非侵入性的脑刺激形式,它利用磁场脉冲刺激特定的大脑区域。目前正在研究视网膜是否受到治疗的影响。视网膜也被称为大脑对外界的窗口。

方法

使用 Magventure X100 设备进行该程序。双侧辅助运动区为目标区域。程序方案:功率:47%,重复率(频率):1Hz,脉冲串持续时间:300,脉冲串之间的间隔(等待时间):120 秒,脉冲串数:4,总脉冲数:1200。计划为患者进行 20 次 rTMS。向患者介绍了该程序,并获得了她的同意。

结果

第一次治疗前的耶鲁-布朗强迫症量表(YBOCS)评分为 31,布朗评估信念量表(BABS)评分为 5。患者第 15 次治疗后的 YBOCS 评分为 14,BABS 评分为 0。在实施第 15 次治疗后,患者右眼发生视网膜脱离,治疗终止。对患者进行眼部检查后,发现左眼下半部有 1 个马蹄形破裂和 2 个孔状破裂。

结论

可能发生视网膜脱离的患者可能需要专门的治疗和密切监测,以防止病情恶化。在进行 TMS 治疗之前,对于有发生视网膜脱离风险的患者,咨询眼科医生非常重要。

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