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一项回顾性病历审查,以评估α引导的经颅磁刺激对现役特种作战部队成员创伤后应激障碍(PTSD)和抑郁症状的影响。

A retrospective chart review to assess the impact of alpha-guided transcranial magnetic stimulation on symptoms of PTSD and depression in active-duty special operations service members.

作者信息

Bailar-Heath Marybeth, Burke Riley, Thomas Delisha, Morrow Chad D

机构信息

Human Performance Optimization Department, Brain Health Clinic, Air Force Special Operations Command (AFSOC) Geographically Separated Unit (GSU), Fayetteville, NC, United States.

出版信息

Front Psychiatry. 2024 Jun 21;15:1354763. doi: 10.3389/fpsyt.2024.1354763. eCollection 2024.

Abstract

INTRODUCTION

Special Operations Forces service members (SOF) are regularly exposed to traumatic and concussive events, increasing the prevalence of symptoms of post-traumatic stress disorder (PTSD) and depression, shortening potential years of service.

METHODS

This retrospective chart review presents preliminary data on a Human Performance Optimization (HPO) program that provided an average of 30 sessions of individualized alpha frequency repetitive transcranial magnetic stimulation (α-rTMS) to active-duty SOF as to reduce symptoms of PTSD and depression following traumatic brain injury. Scores from the PTSD Checklist for DSM-5, PROMIS Depression short form and Perceived Deficits Questionnaire (PDQ) were reviewed.

RESULTS

Significant reductions were noted after the HPO program in all clinical scales with an average 37% decrease in PCL-5 (<.01), 11.3% reduction in PROMIS depression T-scores (<.01), and 45.5% reduction in PDQ scales by session 30 (<.01), with side effects matching those commonly reported in rTMS. Importantly, the average PCL-5 score decreased from 42.9 to 27 by end of the treatment program, which is below the clinical threshold of 33 for presence of PTSD. For those with depression symptoms scores greater than cut off clinical thresholds at baseline, 46% resolved following treatment.

CONCLUSION

This data provides preliminary support for safe application of α-rTMS for symptom reduction in active-duty special operations military personnel.

摘要

引言

特种作战部队(SOF)成员经常暴露于创伤性和震荡性事件中,这增加了创伤后应激障碍(PTSD)和抑郁症症状的患病率,缩短了潜在的服役年限。

方法

本回顾性图表审查展示了一项人类性能优化(HPO)计划的初步数据,该计划为现役特种作战部队成员平均提供30次个体化的阿尔法频率重复经颅磁刺激(α-rTMS),以减轻创伤性脑损伤后创伤后应激障碍和抑郁症的症状。审查了《精神疾病诊断与统计手册》第5版创伤后应激障碍检查表、患者报告结果测量信息系统(PROMIS)抑郁症简表和感知缺陷问卷(PDQ)的得分。

结果

在HPO计划实施后,所有临床量表均有显著降低,到第30次治疗时,PCL-5平均降低37%(<.01),PROMIS抑郁症T评分降低11.3%(<.01),PDQ量表降低45.5%(<.01),副作用与rTMS常见报告的副作用相符。重要的是,到治疗计划结束时,PCL-5平均得分从42.9降至27,低于创伤后应激障碍临床阈值33。对于那些基线时抑郁症症状评分高于临床阈值临界值的患者,46%在治疗后症状得到缓解。

结论

该数据为α-rTMS在现役特种作战军事人员中安全应用以减轻症状提供了初步支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/404a/11224515/d1ea93de4436/fpsyt-15-1354763-g001.jpg

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