Bernabei Laura, Leone Beniamino, Hirsch Daniele, Mentuccia Valentina, Panzera Alessia, Riggio Francesco, Sangiovanni Loredana, Piserchia Valentina, Nicolò Giuseppe, Pompili Enrico
Department of Mental Health and Addiction, Psychiatric Service of Diagnosis and Care-ASL Rome 5, Colleferro, 00034 Rome, Italy.
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazza Aldo Moro, 100165 Rome, Italy.
Behav Sci (Basel). 2024 Dec 8;14(12):1176. doi: 10.3390/bs14121176.
Bipolar disorder is a debilitating psychiatric condition characterized by recurrent episodes of mania and depression, affecting millions worldwide. While pharmacotherapy remains the cornerstone of treatment, a significant proportion of patients exhibit inadequate response or intolerable side effects to conventional medications. In recent years, neuromodulation techniques have emerged as promising adjunctive or alternative treatments for bipolar disorder. We performed a narrative review, according to the Scale for the Assessment of Narrative Review Articles (SANRA) guidelines, to provide a comprehensive overview of the current literature on neuromodulation interventions in bipolar disorder across the course of lifespan. Specifically, it examines the efficacy, safety, and mechanisms of action of various neuromodulation strategies, including, among others, transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), deep brain stimulation (DBS), and it describes the therapeutic experiences across the different ages of illness. Additionally, this review discusses the clinical implications, challenges, and future directions of the integration, in clinical practice, of neuromodulation into the management of bipolar disorder. By synthesizing evidence from different studies, this review aims to inform clinicians, researchers, and stakeholders about the evolving landscape of neuromodulation treatments and their potential role in improving outcomes for individuals with bipolar disorder.
双相情感障碍是一种使人衰弱的精神疾病，其特征为躁狂和抑郁反复发作，影响着全球数百万人。虽然药物治疗仍然是治疗的基石，但相当一部分患者对传统药物表现出反应不足或难以忍受的副作用。近年来，神经调节技术已成为双相情感障碍有前景的辅助或替代治疗方法。我们根据叙事性综述文章评估量表（SANRA）指南进行了一项叙事性综述，以全面概述目前关于双相情感障碍全生命周期神经调节干预的文献。具体而言，它研究了各种神经调节策略的疗效、安全性和作用机制，包括经颅磁刺激（TMS）、电休克治疗（ECT）、迷走神经刺激（VNS）、深部脑刺激（DBS）等，并描述了不同发病年龄阶段的治疗经验。此外，本综述讨论了在临床实践中将神经调节纳入双相情感障碍管理的临床意义、挑战和未来方向。通过综合不同研究的证据，本综述旨在让临床医生、研究人员和利益相关者了解神经调节治疗的不断发展的情况及其在改善双相情感障碍患者预后方面的潜在作用。
