An open study of repetitive transcranial magnetic stimulation in treatment-resistant depression with Parkinson's disease
An open study of repetitive transcranial magnetic stimulation in treatment-resistant depression with Parkinson's disease
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DOI：
10.1016/j.clinph.2007.07.010
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发表时间：
2007-10-01
影响因子：
4.7
通讯作者：
DeLong, Mahlon R.
中科院分区：
文献类型：
--
作者：
Epstein, Charles M.;Evatt, Marian L.;DeLong, Mahlon R.
目的：重度抑郁症是慢性中枢神经系统疾病，尤其是帕金森病（PD）的常见伴发病。重复性经颅磁刺激（rTMS）作为PD抑郁症和PD运动障碍的潜在治疗方法已被研究，但在单一研究中很少进行多领域表现的综合测试。我们研究了左背外侧前额叶rTMS对几个不同功能域的影响。方法：14名患有治疗难治性抑郁症的PD患者进入了一项开放的、为期10天的10-Hz rTMS住院研究，从基线到治疗后6周进行了广泛的精神病学、神经心理学和运动测试。电机测试包括一个定义的“关闭”状态。结果：rTMS患者耐受性良好。治疗后3天和3-6周抑郁评分均有显著改善。焦虑、运动得分（尤其是在关机状态下）和一些神经心理学指标也有所改善。在这一人群中，我们没有发现rTMS增加风险的证据。结论：rTMS治疗PD的进一步对照试验似乎是值得的，并且应该包括一个明确的“关闭”状态。意义：经颅磁刺激可能对抑郁症PD患者的多个功能域有益。(C) 2007年国际临床神经生理学联合会。爱思唯尔爱尔兰有限公司出版。版权所有。
Objective: Major depression is a common concomitant of chronic central nervous system disorders, notably Parkinson's disease (PD). Repetitive transcranial magnetic stimulation (rTMS) has been investigated as a potential treatment for depression in PD and for the movement disorder of PD, but comprehensive testing in multiple areas of performance has seldom been carried out within a single study. We studied the effect of left dorsolateral prefrontal rTMS on several different functional domains.Methods: Fourteen PD patients with treatment-resistant depression entered an open, 10-day inpatient study of 10-Hz rTMS, undergoing extensive psychiatric, neuropsychological, and motor testing from baseline to 6 weeks after treatment. Motor testing included a defined "off" state.Results: rTMS was well tolerated. Highly significant improvement in depression scores was seen 3 days and 3-6 weeks after treatment. Improvement was also found in anxiety, movement scores (especially in the off state), and some neuropsychological measures. We found no evidence of increased risk from rTMS in this population.Conclusions: Further controlled trials of rTMS in PD appear worthwhile, and should include a defined "off" state.Significance: TMS may be beneficial for depressed PD patients in multiple functional domains. (C) 2007 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.