Neuroanatomical correlates of therapeutic efficacy of low-frequency right prefrontal transcranial magnetic stimulation in treatment-resistant depression
Neuroanatomical correlates of therapeutic efficacy of low-frequency right prefrontal transcranial magnetic stimulation in treatment-resistant depression
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DOI：
10.1111/j.1440-1819.2010.02183.x
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发表时间：
2011-01-01
影响因子：
11.9
通讯作者：
Koga, Yoshihiko
中科院分区：
文献类型：
--
作者：
Kito, Shinsuke;Hasegawa, Takashi;Koga, Yoshihiko
目的：低频经颅磁刺激（TMS）的右前额叶皮层已被证明是有效的治疗难治性抑郁症。本研究的目的是探讨低频右前额叶刺激（LFRS）后局部脑血流量（rCBF）的变化，LFRS在治疗难治性depression.Methods：26例难治性抑郁症患者接受了5个60秒1-Hz的列车在右前额叶皮层，12个疗程，在3周内进行了管理。在LFRS前后使用Tc-99 m-乙基半胱氨酸二聚体进行单光子发射计算机断层扫描获得脑扫描。结果：LFRS后右半球前额叶、眶额、扣带回、苍白球、丘脑、前、后丘脑和中脑的rCBF明显降低。结论：LFRS对难治性抑郁症的抗抑郁作用可能与右前额叶、双侧眶额皮质、右膝下扣带回皮质、右壳核和右前额叶的rCBF降低有关，其机制可能是通过右前额叶降低眶额皮质和膝下扣带回皮质的rCBF。
Aims: Low-frequency transcranial magnetic stimulation (TMS) to the right prefrontal cortex has been shown to be effective in treatment-resistant depression. The aim of the present study was to investigate changes in regional cerebral blood flow (rCBF) after low-frequency right prefrontal stimulation (LFRS), and neuroanatomical correlates of therapeutic efficacy of LFRS in treatment-resistant depression.Methods: Twenty-six patients with treatment-resistant depression received five 60-s 1-Hz trains over the right prefrontal cortex, and 12 treatment sessions were administered during 3 weeks. Brain scans were acquired before and after LFRS using single photon emission computed tomography with Tc-99m-ethyl cysteinate dimer. Severity of depression was assessed on the Hamilton Depression Rating Scale (HDRS).Results: Significant decreases in rCBF after LFRS were seen in the prefrontal cortex, orbitofrontal cortex, subgenual cingulate cortex, globus pallidus, thalamus, anterior and posterior insula, and midbrain in the right hemisphere. Therapeutic efficacy of LFRS was correlated with decreases in rCBF in the right prefrontal cortex, bilateral orbitofrontal cortex, right subgenual cingulate cortex, right putamen, and right anterior insula.Conclusion: The antidepressant effects of LFRS in treatment-resistant depression may be associated with decreases in rCBF in the orbitofrontal cortex and the subgenual cingulate cortex via the right prefrontal cortex.