Department of Mood and Anxiety, Institute of Mental Health, Singapore.
Singapore Med J. 2024 Oct 1;65(10):544-551. doi: 10.4103/singaporemedj.SMJ-2024-133. Epub 2024 Oct 4.
Transcranial magnetic stimulation (TMS) is a promising intervention for treatment-resistant psychiatric disorders. However, conventional TMS typically utilises a one-size-fits-all approach when determining stimulation targets. Recent retrospective brain circuit-based analyses using lesion network mapping have suggested that a left dorsal lateral prefrontal cortex target has a higher efficacy for alleviating depression symptoms, a dorsomedial prefrontal cortex target is more effective for anxiety symptoms, and a rostromedial prefrontal cortex target is effective for schizophrenia-associated psychiatric symptoms. Nonetheless, symptom-specific brain circuit targeting has not been tested prospectively. We conducted a narrative review of selected literature to investigate individualised targeting for TMS and discuss potential future directions to elucidate the efficacy of this approach.
经颅磁刺激(TMS)是一种有前途的治疗抵抗性精神障碍的干预手段。然而,传统的 TMS 在确定刺激靶点时通常采用一刀切的方法。最近使用基于损伤网络映射的回顾性大脑回路分析表明,左侧背外侧前额叶皮层的靶点对于缓解抑郁症状更有效,背内侧前额叶皮层的靶点对于焦虑症状更有效,而前脑回前额叶皮层的靶点对于与精神分裂症相关的精神症状有效。然而,针对特定症状的大脑回路靶向治疗尚未进行前瞻性测试。我们对选定文献进行了叙述性综述,以研究 TMS 的个体化靶向,并讨论潜在的未来方向,以阐明这种方法的疗效。