Neuromodulation Treatments for Geriatric Mood and Cognitive Disorders

被引:21
作者
McDonald, William M. [1 ]
机构
[1] Emory Univ, Dept Psychiat & Behav Sci, Atlanta, GA 30322 USA
关键词
Depression; TMS; tDCS; ECT; DBS; neuromodulation; dementia; TRANSCRANIAL MAGNETIC STIMULATION; DEEP BRAIN-STIMULATION; TREATMENT-RESISTANT DEPRESSION; ADMINISTERED SEIZURE THERAPY; UNILATERAL ELECTROCONVULSIVE-THERAPY; VENTRAL CAPSULE/VENTRAL STRIATUM; RANDOMIZED CONTROLLED-TRIAL; VAGUS NERVE-STIMULATION; SHAM-CONTROLLED TRIAL; MAJOR DEPRESSION;
D O I
10.1016/j.jagp.2016.08.014
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
There is increasing evidence for the efficacy of neuromodulation in the treatment of resistant mood disorders and emerging data supporting the use of neuromodulation in cognitive disorders. A significant minority of depressed elders do not respond to pharmacotherapy and/or psychotherapy. This has led clinicians to recommend the increasing use of electroconvulsive therapy (ECT) in the treatment of medication-resistant or life-threatening geriatric depression. Multiple studies have supported the safety and efficacy of ECT in the elderly, yet ECT is associated with side effects including cardiovascular and cognitive side effects. Neuromodulation therapies have the potential for providing effective treatment for treatment-resistant older adults with reduced side effects and this review will outline the risks and benefits of neuromodulation treatment in geriatric psychiatry. There is also emerging evidence of the efficacy of neuromodulation devices in the treatment of cognitive disorders. Pharmacotherapy has been largely ineffective in changing the course of neurodegenerative diseases causing dementia and other treatments are clearly needed. This review will outline the available evidence for neuromodulation in the treatment of mood and cognitive disorders in the elderly.
引用
收藏
页码:1130 / 1141
页数:12
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