Các phương pháp kích thích não

Der Nervenarzt - Tập 83 - Trang 95-105 - 2012
T.E. Schläpfer1,2, S. Kayser1
1Klinik für Psychiatrie und Psychotherapie, Uniklinikum Bonn, Bonn, Deutschland
2Departments of Psychiatry and Mental Health, The Johns Hopkins University, Baltimore, USA

Tóm tắt

Các phương pháp kích thích não là những lựa chọn điều trị đầy hứa hẹn cho các rối loạn tâm thần nặng, kháng trị. Kích thích từ trường xuyên sọ (TMS) là một phương pháp an toàn và ít xâm lấn, tuy nhiên cho đến nay giá trị của nó trong việc áp dụng lâm sàng vẫn chưa rõ ràng. Một sự phát triển của kích thích từ trường xuyên sọ là liệu pháp co giật từ tính (MBE), trong đó các cơn co giật toàn thân được kích thích với mục đích trị liệu - tương tự như liệu pháp sốc điện - dưới sự gây mê và thư giãn cơ. Những kết quả đến nay liên quan đến tác dụng chống trầm cảm và hồ sơ tác dụng phụ về nhận thức tốt hơn so với liệu pháp sốc điện là rất thuyết phục. Kích thích não sâu là một phương pháp xâm lấn, trong đó các điện cực được cấy vào các vùng mục tiêu xác định thông qua một cuộc phẫu thuật định vị. Tác dụng của nó đối với các rối loạn ám ảnh cưỡng chế nặng kháng trị và trầm cảm là đầy hứa hẹn, tuy nhiên cần xem xét các khía cạnh đạo đức.

Từ khóa

#kích thích não #TMS #liệu pháp co giật từ tính #tác dụng chống trầm cảm #đạo đức trong y học

Tài liệu tham khảo

O’Reardon JP et al (2007) Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry 62:1208–1216 Schlaepfer TE, Kosel M (2005) Brain stimulation in Depression. In: Grietz E et al (Hrsg) Mood disorder. Clinical management and research issues. John Wiley & Sons Ltd, London Lisanby SH (2003) Focal brain stimulation with repetitive transcranial magnetic stimulation (rTMS): implications for the neural circuitry of depression. Psychol Med 33:7–13 George MS et al (2000) A controlled trial of daily left prefrontal cortex TMS for treating depression. Biol Psychiatry 48:962–970 Herwig U et al (2007) Antidepressant effects of augmentative transcranial magnetic stimulation: randomised multicentre trial. Br J Psychiatry 191:441–448 Toyoda H, Zhao MG, Zhuo M (2006) NMDA receptor-dependent long-term depression in the anterior cingulate cortex. Rev Neurosci 17:403–413 Siebner HR et al (1998) Imaging brain activation induced by long trains of repetitive transcranial magnetic stimulation. Neuroreport 9:943–948 Paus T, Castro-Alamancos MA, Petrides M (2001) Cortico-cortical connectivity of the human mid-dorsolateral frontal cortex and its modulation by repetitive transcranial magnetic stimulation. Eur J Neurosci 14:1405–1411 Hayward G et al (2007) Exploring the physiological effects of double-cone coil TMS over the medial frontal cortex on the anterior cingulate cortex: an H2(15)O PET study. Eur J Neurosci 25:2224–2233 Pogarell O et al (2007) Acute prefrontal rTMS increases striatal dopamine to a similar degree as D-amphetamine. Psychiatry Res 156:251–255 Huang CC, Su TP, Wei IH (2005) Repetitive transcranial magnetic stimulation for treating medication-resistant depression in Taiwan: a preliminary study. J Chin Med Assoc 68:210–215 Paulus W (2005) Toward establishing a therapeutic window for rTMS by theta burst stimulation. Neuron 45:181–183 Schonfeldt-Lecuona C et al (2010) The value of neuronavigated rTMS for the treatment of depression. Neurophysiol Clin 40:37–43 Rosenberg O et al (2010) Deep TMS in a resistant major depressive disorder: a brief report. Depress Anxiety 27:465–469 Rowny SB, Benzl K, Lisanby SH (2009) Translational development strategy for magnetic seizure therapy. Exp Neurol 219:27–35 Sackeim HA (1994) Magnetic stimulation therapy and ECT. Convulsive Ther 10:255–258 Lisanby SH et al (2001) Deliberate seizure induction with repetitive transcranial magnetic stimulation in nonhuman primates. Arch Gen Psychiatry 58:199–200 Lisanby SH et al (2001) Magnetic seizure therapy of major depression. Arch Gen Psychiatry 58:303–305 Lisanby SH et al (2003) Safety and feasibility of magnetic seizure therapy (MST) in major depression: randomized within-subject comparison with electroconvulsive therapy. Neuropsychopharmacology 28:1852–1865 Lisanby SH et al (2003) Neurophysiological characterization of magnetic seizure therapy (MST) in non-human primates. Clin Neurophysiol 56 [Suppl]:81–99 Lisanby SH (2002) Update on magnetic seizure therapy: a novel form of convulsive therapy. J ECT 18:182–188 Kayser S et al (2009) Magnetic seizure therapy of treatment-resistant depression in a patient with bipolar disorder. J ECT 25:137–140 Kayser S et al (2011) Antidepressant effects, of magnetic seizure therapy and electroconvulsive therapy, in treatment-resistant depression. J Psychiatr Res 45:569–576 Kirov G et al (2008) Quick recovery of orientation after magnetic seizure therapy for major depressive disorder. Br J Psychiatry 193:152–155 Deng ZD, Lisanby SH, Peterchev AV (2011) Electric field strength and focality in electroconvulsive therapy and magnetic seizure therapy: a finite element simulation study. J Neural Eng 8:016007 Schlaepfer TE Lieb K (2005) Deep brain stimulation for treatment of refractory depression. Lancet 366:1420–1422 Mayberg HS (2003) Modulating dysfunctional limbic-cortical circuits in depression: towards development of brain-based algorithms for diagnosis and optimised treatment. Br Med Bull 65:193–207 Goodman WK et al (2010) Deep brain stimulation for intractable obsessive compulsive disorder: pilot study using a blinded, staggered-onset design. Biol Psychiatry 67:535–542 Mallet L et al (2008) Subthalamic nucleus stimulation in severe obsessive-compulsive disorder. N Engl J Med 359:2121–2134 Greenberg BD et al (2010) Deep brain stimulation of the ventral internal capsule/ventral striatum for obsessive-compulsive disorder: worldwide experience. Mol Psychiatry 15:64–79 Jimenez F et al (2005) A patient with a resistant major depression disorder treated with deep brain stimulation in the inferior thalamic peduncle. Neurosurgery 57:585–593 Aouizerate B et al (2004) Deep brain stimulation of the ventral caudate nucleus in the treatment of obsessive-compulsive disorder and major depression. Case report. J Neurosurg 101:682–686 Sartorius A, Henn FA (2007) Deep brain stimulation of the lateral habenula in treatment resistant major depression. Med Hypotheses 69:1305–1308 Sartorius A et al (2010) Remission of major depression under deep brain stimulation of the lateral habenula in a therapy-refractory patient. Biol Psychiatry 67:9–11 Kosel M et al (2007) Mood improvement after deep brain stimulation of the internal globus pallidus for tardive dyskinesia in a patient suffering from major depression. J Psychiatr Res 41:801–803 Coenen VA et al (2010) Cross-species affective functions of the medial forebrain bundle-Implications for the treatment of affective pain and depression in humans. Neurosci Biobehav Rev 35:1971–1981 Schoene-Bake JC et al (2010) Tractographic analysis of historical lesion surgery for depression. Neuropsychopharmacology 35:2553–2563 Kupferschmidt DA, Zakzanis KK (2011) Toward a functional neuroanatomical signature of bipolar disorder: quantitative evidence from the neuroimaging literature. Psychiatry Res 193:71–79 Marchand WR, Yurgelun-Todd D (2010) Striatal structure and function in mood disorders: a comprehensive review. Bipolar Disord 12:764–785 Bewernick BH et al (2010) Nucleus accumbens deep brain stimulation decreases ratings of depression and anxiety in treatment-resistant depression. Biol Psychiatry 67:110–116 Haq IU et al (2010) A case of mania following deep brain stimulation for obsessive compulsive disorder. Stereotact Funct Neurosurg 88:322–328 Berlin HA, Hamilton H, Hollander E (2008) Experimental therapeutics for refractory obsessive-compulsive disorder: translational approaches and new somatic developments. Mt Sinai J Med 75:174–203 Krishnan V, Nestler EJ (2010) Linking molecules to mood: new insight into the biology of depression. Am J Psychiatry 167:1305–1320 Schlaepfer TE et al (2008) Deep brain stimulation to reward circuitry alleviates anhedonia in refractory major depression. Neuropsychopharmacology 33:368–377 Schlaepfer TE, Fins JJ (2010) Deep brain stimulation and the neuroethics of responsible publishing: when one is not enough. JAMA 303:775–776 Synofzik M, Schlaepfer TE (2008) Stimulating personality: ethical criteria for deep brain stimulation in psychiatric patients and for enhancement purposes. Biotechnol J 3:1511–1520 Fitzgerald PB et al (2003) Transcranial magnetic stimulation in the treatment of depression: a double-blind, placebo-controlled trial. Arch Gen Psychiatry 60:1002–1008 Padberg F et al (2002) Repetitive transcranial magnetic stimulation (rTMS) in major depression: relation between efficacy and stimulation intensity. Neuropsychopharmacology 27:638–645 Loo CK et al (2003) High (15 Hz) and low (1 Hz) frequency transcranial magnetic stimulation have different acute effects on regional cerebral blood flow in depressed patients. Psychol Med 33:997–1006 Kennedy SH et al (2011) Deep brain stimulation for treatment-resistant depression: follow-up after 3–6 years. Am J Psychiatry 168:502–510 Lozano AM et al (2008) Subcallosal cingulate gyrus deep brain stimulation for treatment-resistant depression. Biol Psychiatry 64:461–467 Mayberg HS et al (2005) Deep brain stimulation for treatment-resistant depression. Neuron 45:651–660 Malone D (2011) Use of deep brain stimulation in treatment-resistant depression. Cleve Clin J Med 77:77 Malone DA Jr et al (2009) Deep brain stimulation of the ventral capsule/ventral striatum for treatment-resistant depression. Biol Psychiatry 65:267–275 Bewernick BH et al (2010) Nucleus accumbens deep brain stimulation decreases ratings of depression and anxiety in treatment-resistant depression. Biol Psychiatry 67:110–116 Bewernick BH et al (2011) Long-term effects of deep brain stimulation for treatment-resistant depression – evidence for sustained efficacy. (Submitted) Grubert C et al (2011) Neuropsychological safety of nucleus accumbens deep brain stimulation for major depression: Effects of 12-month stimulation. World J Biol Psychiatry 12:516–527 Schlaepfer TE et al (2008) Deep brain stimulation to reward circuitry alleviates anhedonia in refractory major depression. Neuropsychopharmacology 33:368–377 Puigdemont D et al (2011) Deep brain stimulation of the subcallosal cingulate gyrus: further evidence in treatment-resistant major depression. Int J Neuropsychopharmacol 22:1–13