Greenberg B D, George M S, Martin J D, Benjamin J, Schlaepfer T E, Altemus M, Wassermann E M, Post R M, Murphy D L
Laboratory of Clinical Science, NIMH, Bethesda, MD 20892-1264, USA.
Am J Psychiatry. 1997 Jun;154(6):867-9. doi: 10.1176/ajp.154.6.867.
Prefrontal mechanisms are implicated in obsessive-compulsive disorder. The authors investigated whether prefrontal repetitive transcranial magnetic stimulation influenced obsessive-compulsive disorder symptoms.
Twelve patients with obsessive-compulsive disorder were given repetitive transcranial magnetic stimulation (80% motor threshold, 20 Hz/2 seconds per minute for 20 minutes) to a right lateral prefrontal, a left lateral prefrontal, and a midoccipital (control) site on separate days, randomized. The patients' symptoms and mood were rated for 8 hours afterward.
Compulsive urges decreased significantly for 8 hours after right lateral prefrontal repetitive transcranial magnetic stimulation, but there were nonsignificant increases in compulsive urges after repetitive transcranial magnetic stimulation of the midoccipital site. A shorter-lasting (30 minutes), modest, and nonsignificant reduction in compulsive urges occurred after left lateral prefrontal repetitive transcranial magnetic stimulation. Mood improved during and 30 minutes after right lateral prefrontal stimulation.
These preliminary results suggest that right prefrontal repetitive transcranial magnetic stimulation might affect prefrontal mechanisms involved in obsessive-compulsive disorder.
前额叶机制与强迫症有关。作者研究了前额叶重复经颅磁刺激是否会影响强迫症症状。
12名强迫症患者在不同日期分别接受对右侧前额叶、左侧前额叶和枕叶中部（对照）部位的重复经颅磁刺激（80%运动阈值，20赫兹/每分钟2秒，共20分钟），刺激顺序随机。之后对患者的症状和情绪进行8小时的评估。
右侧前额叶重复经颅磁刺激后，强迫冲动在8小时内显著减少，但枕叶中部重复经颅磁刺激后强迫冲动有不显著的增加。左侧前额叶重复经颅磁刺激后，强迫冲动出现了持续时间较短（30分钟）、程度较轻且不显著的减少。右侧前额叶刺激期间及刺激后30分钟情绪有所改善。
这些初步结果表明，右侧前额叶重复经颅磁刺激可能会影响与强迫症有关的前额叶机制。
