A Critical Review and Synthesis of Clinical and Neurocognitive Effects of Noninvasive Neuromodulation Antidepressant Therapies.
A Critical Review and Synthesis of Clinical and Neurocognitive Effects of Noninvasive Neuromodulation Antidepressant Therapies.
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DOI：
10.1176/appi.focus.20180031
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发表时间：
2019-01
期刊：
影响因子：
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通讯作者：
S. McClintock;E. Kallioniemi;D. Martin;Joseph U. Kim;S. Weisenbach;C. Abbott
中科院分区：
文献类型：
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作者：
S. McClintock;E. Kallioniemi;D. Martin;Joseph U. Kim;S. Weisenbach;C. Abbott
在精神科治疗重度抑郁症的设备中，有过多的当前和新兴的抗抑郁疗法。非侵入性神经调节疗法是这样的治疗类别之一;它们通常涉及电或磁刺激的经颅应用以调节皮质和皮质下脑活动。虽然电休克治疗（ECT）自20世纪30年代以来一直在使用，但随着重性抑郁症和难治性抑郁症（TRD）的流行，过去三十年来，非侵入性神经调节抗抑郁治疗的发展激增。本批判性综述旨在综合关于无创神经调节治疗（包括ECT、经颅磁刺激、磁癫痫发作治疗和经颅直流电刺激）的临床效应、神经认知效应和可能作用机制的信息。大量的研究提供了大量关于其抗抑郁和神经认知作用的信息，但其作用机制仍不清楚。虽然这四种疗法在调节神经回路及其产生的抗抑郁和神经认知作用方面各不相同，但它们对急性和慢性重度抑郁症和TRD患者仍然有用。有必要继续进行研究，以了解剂量测定、给药算法以及非侵入性神经调节疗法之间的整合，并与其他抗抑郁药策略结合，以继续最大限度地提高其安全性和抗抑郁药获益。
There is a plethora of current and emerging antidepressant therapies in the psychiatric armamentarium for the treatment of major depressive disorder. Noninvasive neuromodulation therapies are one such therapeutic category; they typically involve the transcranial application of electrical or magnetic stimulation to modulate cortical and subcortical brain activity. Although electroconvulsive therapy (ECT) has been used since the 1930s, with the prevalence of major depressive disorder and treatment-resistant depression (TRD), the past three decades have seen a proliferation of noninvasive neuromodulation antidepressant therapeutic development. The purpose of this critical review was to synthesize information regarding the clinical effects, neurocognitive effects, and possible mechanisms of action of noninvasive neuromodulation therapies, including ECT, transcranial magnetic stimulation, magnetic seizure therapy, and transcranial direct current stimulation. Considerable research has provided substantial information regarding their antidepressant and neurocognitive effects, but their mechanisms of action remain unknown. Although the four therapies vary in how they modulate neurocircuitry and their resultant antidepressant and neurocognitive effects, they are nonetheless useful for patients with acute and chronic major depressive disorder and TRD. Continued research is warranted to inform dosimetry, algorithm for administration, and integration among the noninvasive neuromodulation therapies and with other antidepressant strategies to continue to maximize their safety and antidepressant benefit.