Rapid-rate transcranial magnetic stimulation of left dorsolateral prefrontal cortex in drug-resistant depression
Rapid-rate transcranial magnetic stimulation of left dorsolateral prefrontal cortex in drug-resistant depression
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DOI：
10.1016/s0140-6736(96)01219-6
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发表时间：
1996-07-27
期刊：
影响因子：
168.9
通讯作者：
Catala, MD
中科院分区：
文献类型：
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作者：
PascualLeone, A;Rubio, B;Catala, MD
研究背景病变和神经影像学研究表明，左前额叶功能障碍与抑郁症有病理生理联系。快速经颅磁刺激（rTMS）对情绪的前额叶偏侧效应在正常情况下，几项初步研究表明，rTMS对抑郁症有有益的影响。然而，充分的对照研究还没有conducted.Methods我们研究了局灶性rTMS对抑郁症状的影响，在17例精神病亚型的耐药抑郁症。本研究设计为多交叉、随机安慰剂对照试验。假rTMS和刺激不同的皮层区域被用作controls.Findings左背外侧前额叶皮层rTMS导致在汉密尔顿抑郁量表HDRS（从25.2至13.8）和自评贝克问卷BQ（从47.9至25.7）的分数显着下降。17名患者中有11名患者在每日rTMS治疗5天后表现出明显的改善，持续约2周。没有病人经历任何显着的不良副作用。解释我们的研究结果强调左背外侧前额叶皮层在抑郁症中的作用，并建议左背外侧前额叶皮层的rTMS可能成为一个安全的，非惊厥性的替代电休克治疗抑郁症。
Background Lesion and neuroimaging studies suggest that left prefrontal lobe dysfunction is pathophysiologically linked to depression. Rapid-rate transcranial magnetic stimulation (rTMS) to prefrontal lateralised effect on mood In normal several preliminary studies suggest a beneficial effect of rTMS on depression. However, adequately controlled studies have not been conducted.Methods We have studied the effects of focal rTMS on the depressive symptoms in 17 patients with medication-resistant depression of psychotic subtype. The study was designed as a multiple cross-over, randomised placebo-controlled trial. Sham rTMS and stimulation of different cortical areas were used as controls.Findings Left dorsolateral prefrontal cortex rTMS resulted in a significant decrease in scores on the Hamilton depression rating scale HDRS (from 25.2 to 13.8) and the self-rated Beck questionnaire BQ (from 47.9 to 25.7). 11 of the 17 patients showed pronounced improvement that lasted for about 2 weeks after 5 days of daily rTMS sessions. No patient experienced any significant undesirable side-effects.Interpretation Our findings emphasise the role of the left dorsolateral prefrontal cortex in depression, and suggest that rTMS of the left dorsolateral prefrontal cortex might become a safe, non-convulsive alternative to electroconvulsive treatment in depression.