High-frequency rTMS treatment increases left prefrontal myo-inositol in young patients with treatment-resistant depression

High-frequency rTMS treatment increases left prefrontal myo-inositol in young patients with treatment-resistant depression
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高频 rTMS 治疗可增加年轻难治性抑郁症患者的左前额叶肌醇

DOI：
10.1016/j.pnpbp.2010.06.009
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发表时间：
2010-10
期刊：
Progress in Neuro-Psychopharmacology and Biological Psychiatry
影响因子：
5.6
通讯作者：
Liu, Jun
Liu, Jun
中科院分区：
医学2区
文献类型：
--
作者：
Zheng, Huirong;Zhang, Zhijun;Li, Zexuan;Men, Weiwei;Zhang, Li;Li, Lingjiang;Liu, Peng;Gao, Junling;Liu, Xiaoyun;Zou, Juan;Zhang, Yan;Liu, Jun

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神经影像学研究表明，前额叶皮层（PFC）参与了重度抑郁症的病理生理过程。重复经颅磁刺激（rTMS）作为一种抗抑郁干预措施，在过去的二十年里越来越多地被研究。本研究采用质子磁共振波谱（1H-MRS）技术评价了重度抑郁症患者经颅磁刺激前后PFC内代谢的变化。方法34例难治性单相抑郁症的年轻抑郁症患者参加了一项双盲、随机研究[活动组（n=19）vs假手术组（n=15），使用3-特斯拉质子磁共振波谱研究高频（15 Hz）rTMS前后的PFC。缓解定义为汉密尔顿抑郁评定量表降低50%。结果与28名年龄和性别匹配的健康对照组进行了比较。抑郁症患者在rTMS前观察到肌醇（m-Ino）显著降低（p<0.001）。成功治疗后，m-Ino在左侧PFC中显著增加，并且水平不再与年龄匹配的对照组不同。除了一个积极的临床改善和增量之间的相关性，在m-Ino的比率，临床改善和早期发病之间的相关性observed.CONCLUSIONSOUR的结果支持这一概念，即严重抑郁症是伴随着状态依赖的代谢改变，特别是在肌醇代谢，这可以部分逆转成功的rTMS。
BACKGROUNDNeuroimaging studies suggest that the prefrontal cortex (PFC) is involved in the pathophysiology of major depression. Repetitive transcranial magnetic stimulation (rTMS) as an antidepressant intervention has increasingly been investigated in the last two decades. In this study metabolic changes within PFC of severely depressed patients before and after rTMS were evaluated by proton magnetic resonance spectroscopy (1H-MRS).METHODThirty-four young depressed patients with treatment-resistant unipolar depression were enrolled in a double-blind, randomized study[active ((n=19) vs. sham(n=15)), and the PFC was investigated before and after high-frequency (15Hz) rTMS using 3-tesla proton magnetic resonance spectroscopy. Response was defined as a 50% reduction of the Hamilton depression rating scale. The results were compared with 28 age- and gender-matched healthy controls.RESULTSIn depressive patients a significant reduction in myo-inositol (m-Ino) was observed pre-rTMS (p<0.001). After successful treatment, m-Ino increased significantly in left PFC and the levels no longer differed from those of age-matched controls. In addition to a positive correlation between clinical improvement and an increment in m-Ino ratio, a correlation between clinical improvement and early age onset was observed.CONCLUSIONSOur results support the notion that major depressive disorder is accompanied by state-dependent metabolic alterations, especially in myo-inositol metabolism, which can be partly reversed by successful rTMS.
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期刊： Progress in brain research
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DOI： 10.1176/appi.ajp.159.4.630
发表时间： 2002-04-01
期刊： AMERICAN JOURNAL OF PSYCHIATRY
影响因子： 17.7
作者：
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通讯作者： Toga, A
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DOI： 10.1038/sj.mp.4001034
发表时间： 2002-01-01
期刊： MOLECULAR PSYCHIATRY
影响因子： 11
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