摘要
近年来安全无创的经颅磁刺激技术在强迫症临床治疗上取得一些新进展。研究发现,刺激靶点的选择对强迫症症状改善有一定影响,一般优先选择背外侧前额叶和辅助运动区。为提高标准方案的效果持续时间,发展了θ爆发式脉冲刺激模式,该模式对强迫症患者来说足够安全但未必有效。与常规刺激方案相比,加速和维持型的增强方案具有更高的时间和临床效益。另外,新近发展的深部经颅磁刺激治疗强迫症的效果尚可,前景可期。总体而言,经颅磁刺激技术治疗强迫症的效果良好,但缺少大样本随机对照试验和评估治疗是否“有效”的统一标准,且研究对象局限于难治性强迫症患者。未来可结合增强方案开展大规模随机对照试验,扩大研究对象选择范围,并建立科学的疗效评估及反馈机制,为强迫症的经颅磁刺激治疗提供科学指南。
In recent years,safe and non-invasive transcranial magnetic stimulation(TMS)has made great progress in the clinical treatment of obsessive-compulsive disorder(OCD).The studies have found that the choice of stimulation targets affects the improvement of symptoms in OCD and dorsolateral prefrontal cortex and supplementary motor area are generally preferred locations.Theta-burst pulse stimulation mode is safe for OCD patients but may not be effective.The accelerated and maintenance enhancement scheme has higher time and clinical effectiveness than the conventional stimulus scheme.The newly developed deep transcranial magnetic stimulation is effective for OCD,and has a bright future.Overall,TMS offers therapeutic benefits for OCD.However,there is a lack of large-sample randomized controlled trials and unified criteria to evaluate the"effectiveness"of treatment.In addition,the subjects are limited to treatmentresistant OCD.In the future,large-scale randomized controlled trials can be combined with an enhancement scheme to expand the selection of subjects and establish a scientific mechanism for efficacy evaluation and feedback,to provide scientific TMS guidance for OCD.
作者
刘月龄
陈璐
朱春燕
LIU Yueling;CHEN Lu;ZHU Chunyan(School of Mental Health and Psychological Sciences,Anhui Medical University,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders,Hefei 230022,China)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2022年第3期178-182,共5页
Chinese Journal of Nervous and Mental Diseases
基金
国家自然科学基金项目(编号:81771456)。
关键词
强迫症
经颅磁刺激
刺激靶点
刺激模式
增强方案
θ爆发式脉冲刺激
深部经颅磁刺激
研究进展
Obsessive-compulsive disorder
Transcranial magnetic stimulation
Stimulation target
Stimulation mode
Enhancement scheme
Theta-burst stimulation
Deep transcranial magnetic stimulation
Research advances
