A practical guide to the use of repetitive transcranial magnetic stimulation in the treatment of depression

被引:77
作者
Fitzgerald, Paul B. [1 ,2 ]
Daskalakis, Zafiris J. [3 ]
机构
[1] The Alfred, Monash Alfred Psychiat Res Ctr, Melbourne, Vic 3004, Australia
[2] Monash Univ, Sch Psychol & Psychiat, Melbourne, Vic 3004, Australia
[3] Univ Toronto, Dept Psychiat, Ctr Addict & Mental Hlth, Toronto, ON, Canada
基金
澳大利亚国家健康与医学研究理事会; 加拿大健康研究院;
关键词
repetitive transcranial magnetic stimulation; depression; prefrontal; administration; maintenance; DORSOLATERAL PREFRONTAL CORTEX; TREATMENT-RESISTANT DEPRESSION; MAJOR DEPRESSION; RANDOMIZED-TRIAL; LOW-FREQUENCY; DOUBLE-BLIND; BIPOLAR DEPRESSION; MOTOR THRESHOLD; OPEN-LABEL; RTMS;
D O I
10.1016/j.brs.2011.03.006
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background Repetitive transcranial magnetic stimulation (rTMS) is currently emerging as a new treatment for patients with mood disorders. Research into the use of rTMS for the treatment of patients with depression has been conducted now for a period of greater than 15 years and a considerable body of knowledge has accumulated informing its use. Objective The aim of this paper was to review the use of various rTMS techniques for the treatment of depression and to provide practical suggestions to address the common issues encountered in the prescribing and administration of rTMS treatment. Methods These suggestions have been informed both by a review of the relevant literature and the experience of the authors in the treatment of many patients with depression with rTMS over a period of 10 years. Results and Conclusions High-frequency rTMS applied to the left dorsolateral prefrontal cortex, using a set of parameters very similar to those originally described in the mid-1990s, is an effective treatment for patients with major depressive disorder. Other forms of stimulation, such as low-frequency stimulation applied to the right prefrontal cortex and bilateral approaches, may prove valuable but require evaluation in larger trials. Significant benefit appears likely to accumulate through the use of methods that involve a more reliable targeting of prefrontal brain regions. Suggestions are also made around the use of rTMS treatment as a maintenance therapy and in specific illness subgroups. (C) 2012 Elsevier Inc. All rights reserved.
引用
收藏
页码:287 / 296
页数:10
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