Efficacy of twice-daily vs once-daily sessions of repetitive transcranial magnetic stimulation in the treatment of major depressive disorder: a retrospective study.
Efficacy of twice-daily vs once-daily sessions of repetitive transcranial magnetic stimulation in the treatment of major depressive disorder: a retrospective study.
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每天两次的疗效与每天一次重复的经颅磁刺激治疗中的疗效：一项回顾性研究。
DOI：
10.2147/ndt.s151841
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发表时间：
2018
影响因子：
3.2
通讯作者：
Wikstrom SL
中科院分区：
文献类型：
--
作者：
Modirrousta M;Meek BP;Wikstrom SL
对于重复性经颅磁刺激(RTMS)治疗重度抑郁障碍(MDD)的最佳方案，临床上尚无共识。建议使用每天一次以上治疗的加速方案作为减少rTMS治疗所需总时间的一种手段。这项研究的目的是比较每天接受两次rTMS治疗的MDD患者和每天接受一次治疗的患者的治疗结果，并保持总脉搏数不变。在一项回顾性研究中，我们比较了36名MDD患者接受30次高频(10赫兹)rTMS左侧前额叶背外侧皮质的治疗结果。患者每次接受3,000次脉冲(5列S列车，25列S列车间间隔)，静息运动阈值的110%使用8字线圈。患者每天接受两次rTMS治疗(n=17)或一次/d治疗(n=19)。精神病学家在基线和每10次rTMS治疗后使用汉密尔顿抑郁评定量表评估抑郁症状。两组中的大多数患者对治疗有反应，每日两次(TD)组的有效率(82.4%)高于每日一次(OD)组(52.6%)。TD刺激对患者来说是可耐受的，且未产生不良反应。由于治疗时间加快，TD组患者的症状改善速度快于OD组。每天两次rTMS治疗疗程对患者来说是可以耐受的，在疗效上似乎并不逊于OD方案。TD管理的好处是在较短的时间内产生症状改善，并且需要较少到诊所就诊。
There is no clinical consensus on the optimal protocol for the treatment of major depressive disorder (MDD) using repetitive transcranial magnetic stimulation (rTMS). Accelerated protocols using more than a single session of treatment per day have been suggested as a means to reduce the overall length of time required for rTMS therapy. The objective of this study is to compare the treatment outcomes of patients with MDD who received two sessions of rTMS per day vs those who received one session per day, keeping the overall number of delivered pulses constant. In a retrospective study, we compared treatment outcomes of 36 patients with MDD who received 30 sessions of high-frequency (10 Hz) rTMS over the left dorsolateral prefrontal cortex. Patients received 3,000 pulses per session (5 s trains, 25 s intertrain interval) at 110% of resting motor threshold using a figure-eight coil. Patients received either two rTMS sessions per day (n=17) or one session per day (n=19). Depression symptoms were assessed by a psychiatrist using the Hamilton Rating Scale for Depression at baseline and after every 10 sessions of rTMS. The majority of patients in both groups responded to treatment, and there was a trend toward greater response rate in the twice-daily (TD) group (82.4%) compared to the once-daily (OD) group (52.6%). TD stimulation was tolerable for patients and produced no adverse side effects. Patients in the TD group experienced an improvement in symptoms faster than the OD group due to the accelerated therapy period. Administration of two rTMS treatment sessions per day is tolerable for patients and does not seem to be inferior in efficacy to a OD protocol. TD administration has the benefit of producing symptom improvement over a shorter time span and requires fewer visits to the clinic.