Repetitive Transcranial Magnetic Stimulation Versus Electroconvulsive Therapy for the Treatment of Major Depressive Disorder, A Randomized Controlled Clinical Trial
Repetitive Transcranial Magnetic Stimulation Versus Electroconvulsive Therapy for the Treatment of Major Depressive Disorder, A Randomized Controlled Clinical Trial
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DOI：
10.1097/yct.0b013e318221b31c
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发表时间：
2011-12-01
期刊：
影响因子：
2.5
通讯作者：
Firoozabadi, Ali
中科院分区：
文献类型：
--
作者：
Keshtkar, Mitra;Ghanizadeh, Ahmad;Firoozabadi, Ali
简介：比较电休克治疗（ECT）和重复经颅磁刺激（rTMS）的抗抑郁作用的研究报告了混合的结果。本研究比较了rTMS和ECT治疗成人难治性抑郁症（MDD）的疗效。方法：本研究采用随机、ECT对照、平行组临床试验，分析了ECT和rTMS治疗73例MDD患者的疗效。结果：ECT和rTMS均能显著改善抑郁和自杀行为，且与对照组相比，差异有统计学意义（P <0.05）。然而，ECT比rTMS更能降低抑郁和自杀行为评分。rTMS组无明显不良反应。讨论：ECT和rTMS均能在短期内改善MDD，但ECT的抗抑郁疗效大于rTMS。此外，ECT比rTMS更能减少自杀行为。在获得rTMS安全性和有效性的有力证据之前，需要进一步研究比较ECT和rTMS的长期复发率和生活质量。
Introduction: Studies comparing the antidepressant effects of electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) have reported mixed results. This study compared the efficacy of rTMS and ECT in adult patients with refractory major depressive disorder (MDD).Methods: This randomized, ECT-controlled, parallel-group clinical trial analyzed the antidepressant effects of ECT and rTMS in 73 patients with MDD diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. The Beck Depression Inventory and Hamilton Depression Rating Scale were used to measure depression.Results: Both ECT and rTMS significantly improved depression and suicidal behavior scores. However, ECT reduced depression and suicidal behavior scores more than rTMS. There were no significant adverse effects in the rTMS group.Discussion: Both ECT and rTMS improved MDD in the short term, but the antidepressant efficacy of ECT was greater than rTMS. Moreover, ECT led to greater reductions in suicidal behavior than rTMS. Until strong evidence for the safety and efficacy of rTMS is available, further studies are needed to compare ECT and rTMS in terms of the long-term relapse rate and quality of life.