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深部经颅磁刺激联合症状激发:对难治性躯体变形障碍患者的有效治疗方法?

Deep Transcranial Magnetic Stimulation in combination with symptom provocation: An effective treatment in patients with treatment-resistant Body Dysmorphic Disorder?

作者信息

Di Ponzio Michele, Pallanti Stefano

机构信息

Department of Psychology and Cognitive Studies, Institute of Neuroscience, Florence, Italy.

Department of Psychiatry and Health Studies, Institute of Neuroscience, Florence, Italy.

出版信息

Neurosci Appl. 2023 Sep 23;2:101137. doi: 10.1016/j.nsa.2023.101137. eCollection 2023.


DOI:10.1016/j.nsa.2023.101137
PMID:40655967
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12243972/
Abstract

Body Dysmorphic Disorder (BDD) concerns an excessive preoccupation concerning a perceived physical defect, associated with function impairment. No FDA-approved treatment exists for BDD, and many patients are resistant to standard treatment. Neuromodulation, especially deep Transcranial Magnetic Stimulation (dTMS) represents an important option in treating resistant patients in the obsessive-compulsive spectrum. No previous studies adopted dTMS in BDD. In this case series we reported the cases of three patients with resistant BDD treated with dTMS in combination with symptom provocation, a cognitive-behavioural therapy technique. Symptoms severity decreased after the treatment in all the three patients. These preliminary data suggested that dTMS plus symptom provocation could be an effective treatment for treatment resistant BDD patients. Further prospective studies are needed.

摘要

躯体变形障碍(BDD)是指过度关注自认为的身体缺陷,并伴有功能损害。目前尚无美国食品药品监督管理局(FDA)批准的针对BDD的治疗方法,许多患者对标准治疗有抵抗性。神经调节,尤其是深部经颅磁刺激(dTMS)是治疗强迫症谱系中抵抗性患者的重要选择。此前尚无研究将dTMS用于BDD治疗。在本病例系列中,我们报告了3例抵抗性BDD患者采用dTMS联合症状激发(一种认知行为治疗技术)进行治疗的病例。所有3例患者治疗后症状严重程度均有所下降。这些初步数据表明,dTMS加症状激发可能是治疗抵抗性BDD患者的有效方法。还需要进一步的前瞻性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/950c/12243972/7c6a90aa7ab1/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/950c/12243972/7c6a90aa7ab1/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/950c/12243972/7c6a90aa7ab1/gr1.jpg

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[1]
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本文引用的文献

[1]
rTMS investigation of resistant Obsessive-Compulsive Related Disorders: Efficacy of targeting the reward system.

Front Psychiatry. 2023-2-3

[2]
Effects of repetitive transcranial magnetic stimulation (rTMS) in patients with body dysmorphic disorder (BDD).

Brain Stimul. 2022

[3]
Can excitatory neuromodulation change distorted perception of one's appearance?

Brain Stimul. 2021

[4]
Body dysmorphic disorder: a treatment synthesis and consensus on behalf of the International College of Obsessive-Compulsive Spectrum Disorders and the Obsessive Compulsive and Related Disorders Network of the European College of Neuropsychopharmacology.

Int Clin Psychopharmacol. 2021-3-1

[5]
A Method to Provoke Obsessive Compulsive Symptoms for Basic Research and Clinical Interventions.

Front Psychiatry. 2019-11-11

[6]
Insula H-coil deep transcranial magnetic stimulation in severe and enduring anorexia nervosa (SE-AN): a pilot study.

Neuropsychiatr Dis Treat. 2019-8-6

[7]
Efficacy and Safety of Deep Transcranial Magnetic Stimulation for Obsessive-Compulsive Disorder: A Prospective Multicenter Randomized Double-Blind Placebo-Controlled Trial.

Am J Psychiatry. 2019-5-21

[8]
Transcranial magnetic stimulation in the treatment of obsessive-compulsive disorder: current perspectives.

Neuropsychiatr Dis Treat. 2018-6-29

[9]
Simultaneous rTMS and psychotherapy in major depressive disorder: Clinical outcomes and predictors from a large naturalistic study.

Brain Stimul. 2017-11-11

[10]
Enhanced cognition and emotional recognition, and reduced obsessive compulsive symptoms in two adults with high-functioning autism as a result of deep Transcranial Magnetic Stimulation (dTMS): a case report.

Neurocase. 2017

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