Transcranial Magnetic Stimulation for the Treatment of Chemo Brain.
Transcranial Magnetic Stimulation for the Treatment of Chemo Brain.
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DOI：
10.3390/s23198017
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发表时间：
2023-09-22
期刊：
影响因子：
--
通讯作者：
Chou YH
中科院分区：
文献类型：
--
作者：
Kuo PH;Chen AY;Rodriguez RJ;Stuehm C;Chalasani P;Chen NK;Chou YH
这项初步可行性研究旨在评估经颅磁刺激（TMS）对化疗相关认知功能障碍（CRCI）的影响，我们在这里报告了第一例患者。背景：化疗或CRCI导致的有害认知变化通常被称为“化疗脑”。随着癌症患者生存率的提高，这种人们知之甚少且治疗不足的疾病同样会对个人和社会造成越来越大的损失。由于没有批准的化疗脑治疗方法，我们已经开始了一项使用经颅磁刺激（TMS）的治疗试验，这是一种在许多国家被批准用于治疗偏头痛和抑郁症等神经和精神疾病的非侵入性脑刺激技术。病例介绍：一名58岁女性，7年前诊断为左侧乳腺癌，接受了部分乳房切除术和前哨淋巴结活检。然后，她接受了四个周期的辅助化疗，然后进行放射治疗。之后，她服用他莫昔芬4年，然后改用芳香酶抑制剂。患者的CRCI在化疗期间开始，并严重损害了她的生活质量，持续了两年。在化疗后第三年，CRCI部分清除，稳定到本试验时的水平。患者持续存在记忆困难和注意力下降，这使得多任务处理变得非常困难甚至不可能。她在工作和家里都依赖记忆辅助工具。参与者在工作日连续接受了10次TMS治疗，持续2周。刺激针对左侧背外侧前额叶皮质。经颅磁刺激后，参与者在神经心理学测试中的记忆功能显着改善。虽然她报告说在注意力或记忆力方面没有主观差异，但她确实报告说她的睡眠有所改善。经颅磁刺激前后的脑功能磁共振成像显示，刺激部位和几个脑区之间的静息态功能连接增加。值得注意的是，经过6年的化疗大脑，由于她无法集中注意力和多任务，她在工作中保持相同的位置，她在TMS治疗后5-6个月申请并获得晋升。结论：第一位患者在第一阶段临床试验中测试TMS治疗“化疗脑”，为可行性和了解潜在益处的机制提供了重要的经验教训。
This pilot feasibility study aimed to evaluate the effects of transcranial magnetic stimulation (TMS) on chemotherapy-related cognitive impairment (CRCI), and we report here on the first patient. Background: Deleterious cognitive changes due to chemotherapy or CRCI are commonly referred to as “chemo brain”. With the increasing survival of cancer patients, this poorly understood and inadequately treated condition will likewise have an increasing toll on individuals and society. Since there is no approved treatment for chemo brain, we have initiated a therapeutic trial using transcranial magnetic stimulation (TMS), a non-invasive brain stimulation technique approved in many countries for the treatment of neurologic and psychiatric conditions like migraine and depression. Case presentation: A 58-year-old woman, diagnosed 7 years prior with left breast cancer, underwent partial mastectomy with sentinel lymph node biopsy. She then received four cycles of adjuvant chemotherapy followed by radiation therapy. Afterwards, she was on tamoxifen for 4 years and then switched to aromatase inhibitors. The patient’s CRCI started during chemotherapy and severely impaired her quality of life for an additional two years. In the third year after chemotherapy, the CRCI partially cleared to stabilize to the level at the time of presentation for this trial. The patient continues to have memory difficulties and decreased concentration, which makes multi-tasking very difficult to impossible. She is reliant on memory aids at work and at home. The participant underwent 10 consecutive sessions of TMS during weekdays for 2 weeks. Stimulation was directed to the left dorsolateral prefrontal cortex. After TMS, the participant significantly improved in memory function on neuropsychological testing. While she reported no subjective differences in concentration or memory, she did report an improvement in her sleep. Functional magnetic resonance imaging of the brain before and after TMS showed increased resting-state functional connectivity between the stimulation site and several brain regions. Remarkably, after 6 years of chemo brain and remaining in the same position at work due to her inability to concentrate and multi-task, she applied for and received a promotion 5–6 months after her TMS treatments. Conclusions: This first patient in the phase 1 clinical trial testing of TMS for the treatment of “chemo brain” provided important lessons for feasibility and insights into mechanisms of potential benefit.
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DOI：
10.1080/13803390903032537
发表时间：
2010-01-01
影响因子：
2.2
作者：
Cimprich, Bernadine;Reuter-Lorenz, Patricia;Welsh, Robert C.
通讯作者：
Welsh, Robert C.
影响因子：
25
作者：
Gent TC;Bandarabadi M;Herrera CG;Adamantidis AR
通讯作者：
Adamantidis AR
DOI：
10.1097/jgp.0b013e31819431d5
发表时间：
2009-05
期刊：
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
影响因子：
--
作者：
Jak AJ;Bondi MW;Delano-Wood L;Wierenga C;Corey-Bloom J;Salmon DP;Delis DC
通讯作者：
Delis DC
叙述性综述了与癌症相关认知障碍的危险因素和干预措施。
影响因子：
--
作者：
Bai L;Yu E
通讯作者：
Yu E
影响因子：
4.7
作者：
Donovan, KA;Jacobsen, PB;McGrath, P
通讯作者：
McGrath, P