增加的诱导和减少的兴奋性预测了闭环相锁rTMS对治疗耐药抑郁症的有效治疗
medRxiv : the preprint server for health sciences
|October 24, 2023
概括
同步重复性跨脑磁性刺激 (rTMS) 通过调整到个人的大脑活动来治疗抑郁症. 这种个性化的方法提高了治疗效率,并允许早期预测患者的反应.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 生物医学工程 生物医学工程
背景情况:
- 经磁刺激 (TMS) 是FDA批准的治疗耐药性抑郁症 (TRD),但疗效不同,约50%的患者没有反应.
- 目前的TMS缺乏用于目标参与和早期疗效评估的生物标志物,阻碍了治疗优化.
- 个体患者的变化是限制TMS在重大抑郁症 (MDD) 疗效的一个关键因素.
研究的目的:
- 研究一个闭环,相锁重复性TMS (rTMS) 系统,用于个性化抑郁症治疗.
- 为了确定目标参与的生物标志物,并预测在rTMS治疗期间的临床结果.
- 评估同步rTMS与非同步控制相比是否提高了疗效.
主要方法:
- 开发了一个闭环rTMS系统,同步刺激与个体脑电图 (EEG) 前额头α振荡,由fMRI告知.
- 向治疗耐药抑郁症患者给予同步和非同步的rTMS.
- 监测大脑动态,包括皮层刺激性和阶段携带,并每周与临床结果相关联.
主要成果:
- 在响应者中同步的rTMS降低了全局皮质刺激性和增加了皮质阶段携带.
- 这些大脑动态的变化预测了同步组的临床结果,但不是对照组.
- 这些生物标志物的每周跟踪与治疗疗效相关,使得早期预测和潜在的动态治疗调整成为可能.
结论:
- 同步的rTMS证明了在主要抑郁症中改善治疗疗效的潜力.
- 来自EEG和fMRI的生物标志物可以预测TMS治疗反应.
- 每周对这些生物标志物的跟踪可能会使治疗的动态调整成为可能,以改善患者的治疗结果.
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