Treating the depressions with superficial brain stimulation methods.
Treating the depressions with superficial brain stimulation methods.
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DOI：
10.1016/b978-0-444-53497-2.00033-4
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发表时间：
2013-01-01
影响因子：
--
通讯作者：
Short, Baron
中科院分区：
文献类型：
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作者：
George, Mark S;Taylor, Joseph J;Short, Baron
许多，如果不是大多数，不同的浅表脑刺激方法正在使用或研究治疗抑郁症。有可能有很多原因，为什么有这么多的兴趣和研究涉及脑刺激治疗抑郁症，包括抑郁症是常见的，有与其他治疗的不满，有些患者不响应药物或谈话疗法。与此同时，抑郁发作是大脑的一种周期性或暂时性状态，当患者不再处于这种状态时，他们会恢复正常功能。此外，最古老的脑刺激方法，电休克治疗（ECT），也是最有效的抗抑郁药，可用于对药物无反应的患者的抑郁症的急性治疗。新的大脑刺激方法遵循了ECT开辟的道路，表明刺激关键区域可以改变大脑状态并治疗抑郁症。经过近20年的研究，每天重复经颅磁刺激（rTMS）的前额叶皮层几个星期，现在也是一个既定的临床治疗急性发作。其他脑刺激方法的数据不太令人信服，但所有方法都在研究中。使用脑刺激（而不是药物或谈话疗法）来治疗抑郁症是一个迅速扩大的研究领域，已经建立了明确的适应症。需要做更多的工作来了解哪些方法应该用于任何特定的患者，以及以什么顺序。
Many, if not most, of the different superficial brain stimulation methods are being either used or investigated to treat the depressions. There are likely many reasons why there is this much interest and research involving brain stimulation treatments for depression, including that the depressions are common, there is dissatisfaction with other treatments, and some patients do not respond to medications or talking therapies. This is coupled with the fact that depressive episodes are a periodic or temporary state of the brain, and that when patients are no longer in that state they return to normal functioning. Additionally, the oldest brain stimulation method, electroconvulsive therapy (ECT), is also the most effective antidepressant available for the acute treatment of depression in patients who do not respond to medications. The newer brain stimulation methods have followed in the path blazed by ECT, showing that stimulation of key regions can cause a change in brain state and treat the depression. After almost 20 years of research, repeated daily repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex for several weeks is now also an established clinical treatment for acute episodes. The data are less convincing for the other brain stimulation methods, but all are being investigated. Using brain stimulation (as opposed to medications or talking therapy) to treat depression is a rapidly expanding area of research with already established clear indications. Much more work is needed to understand best which methods should be used in any given patient, and in what order.