双边rTMS在抑郁症和并发性抑郁症和焦虑症方面没有任何优势:一项自然主义研究
Rebecca M Allen1,2, James M Scanlan3, Larissa Gama-Chonlon4
1Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA. Rebecca.allen@seattlentc.com.
The Psychiatric quarterly
|December 21, 2023
概括
与标准的左侧单侧TMS (LUL) 相比,结合左侧和右侧横磁刺激 (TMS) 的顺序双边治疗 (SBT) 并没有改善抑郁或焦虑的结果. 在治疗中期切换协议与更糟糕的结果有关.
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.
- 医疗器械 医疗器械
背景情况:
- 重复性跨磁刺激 (rTMS) 是一种非侵入性神经调节技术,用于治疗严重抑郁症.
- 标准的rTMS协议通常涉及高频左侧刺激 (LUL).
- 连续双边治疗 (SBT),将LUL与低频右侧rTMS相结合,是一种用于提高疗效的替代方案.
研究的目的:
- 调查顺序双边治疗 (SBT) 对抑郁和焦虑症状的标准左侧单边治疗 (LUL) 是否提供额外的好处.
- 为了比较LUL与SBT在患有重度抑郁症的患者中的疗效.
主要方法:
- 在2015年1月至2018年12月期间,对275名因重大抑郁症发作而接受治疗的患者进行了回顾性图表审查.
- 患者接受了LUL或SBT,使用图形-8卷.
- 评估结果使用了通用焦虑障碍7项表格 (GAD-7) 和患者健康问卷 (PHQ-9).
主要成果:
- 在LUL和SBT组之间没有观察到GAD-7或PHQ-9变化得分的显著差异.
- 这一发现甚至在分析子组时也是如此,包括最初高GAD-7分数的患者.
- 在治疗期间从LUL转换为SBT的患者表现较差,与维持一致方案的患者相比.
结论:
- 顺序双边治疗 (SBT) 在主要抑郁症发作中对抑郁症或焦虑症的标准左侧单边治疗 (LUL) 没有显著的优势.
- 这些发现表明,像SBT这样的组合rTMS协议可能不会更有效,并且如果在治疗过程中切换治疗,可能效果会更差.
- 这项研究建议谨慎对综合rTMS协议的广泛采用而没有进一步的益处证据.
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