Low frequency rTMS stimulation of the right frontal cortex is as effective as high frequency rTMS stimulation of the left frontal cortex for antidepressant-free, treatment-resistant depressed patients.
Low frequency rTMS stimulation of the right frontal cortex is as effective as high frequency rTMS stimulation of the left frontal cortex for antidepressant-free, treatment-resistant depressed patients.
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DOI：
10.1080/10401230591002110
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发表时间：
2005-07-01
期刊：
影响因子：
--
通讯作者：
Kormos, Theresa C
中科院分区：
文献类型：
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作者：
Isenberg, Keith;Downs, Dana;Kormos, Theresa C
背景：重复经颅磁刺激（rTMS）是治疗抑郁症的一种有前途的相对非侵入性替代方法。本研究的目的是比较高频率的明显效果，（20 Hz）rTMS应用于左侧背外侧前额叶皮层（DLPFC），低频（1 Hz）rTMS应用于右侧DLPFC。方法：28例未使用抗抑郁药的重度抑郁症（n = 25）或双相情感障碍（n = 3）成人（不使用情绪稳定剂）在当前的严重抑郁症中（汉密尔顿抑郁量表[HAM-D-21] ≥ 18;平均值= 24.5，SD = 5.51）（右14例，左14例）持续4周。总体配对t检验显示，平均HAM-D-21，贝克抑郁量表（BDI-II），两组（高频左侧DLPFC和低频右侧DLPFC）治疗结束时的临床总体印象变化（CGIC）评分。发现的治疗缓解率（32%）是文献中报告的其他缓解率的典型结果（6，30）。从50%的参与者中获得了一个月的随访数据。在1个月随访时，与末次治疗访视时的患者表现相比，未观察到显著差异，表明rTMS治疗随时间推移具有中等稳健性。此外，磁刺激并没有实质性地改变病人的记忆力在整个治疗course.CONCLUSION：rTMS给予在右额叶皮层低频似乎是有效的治疗难治性抑郁症的高频治疗在左额叶皮层。
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) is a promising relatively non-invasive alternative for the treatment of depression. The purpose of this study was to compare the apparent effectiveness of high frequency (20 Hertz) rTMS applied over the left dorsolateral prefrontal cortex (DLPFC) with that of low frequency (1 Hz) rTMS applied over the right DLPFC METHODS: Twenty-eight antidepressant-free adults with major depressive (n = 25) or bipolar (n = 3) disorder (not on mood stabilizers) in a current major depression (Hamilton Rating Scale for Depression [HAM-D-21] > or = 18; Mean = 24.5, SD = 5.51) were treated (14 right, 14 left) for 4 weeks.RESULTS: Overall paired t-tests revealed a significant reduction in mean HAM-D-21, Beck Depression Inventory (BDI-II), and Clinical Global Impression of Change (CGIC) scores at the end of treatment for both groups (high frequency left DLPFC and low frequency right DLPFC). The treatment response rate found (32%) was typical of other response rates reported in the literature (6,30). One-month follow-up data was obtained from 50% of participants. At 1-month follow-up no significant differences were noted as compared to patients' performance at last treatment visit, indicating moderate robustness of rTMS treatment over time. Furthermore, magnetic stimulation did not substantially alter patient memory over the course of treatment.CONCLUSION: rTMS given at low frequency over the right frontal cortex appears to be as effective treatment of refractory depression as high frequency treatment over the left frontal cortex.