重复经颅磁刺激治疗广泛性焦虑障碍的新进展
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v4i2.4991
Abstract
广泛性焦虑障碍(Generalized Anxiety Disorder,GAD)是以焦虑症为主要临床表现的的精神障碍。其标志是过度、失控的担忧,会对患者的心理及生活产生负面影响。目前GAD的一线疗法还有药物和心理疗法,但药物治疗不良反应大、依从性差,且仍有部分患者治疗无效。因此,针对广泛性焦虑障碍的替代疗法显得尤为必要。目前相关研究已经指出,重复经颅磁刺激可能成为GAD的一种医疗新选择。重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)是一项使用经脉冲磁场作用于人脑,以直接影响脑内代谢过程与神经电活动,进而诱发各种生理生化反应的电磁脉冲技术。其具有三大技术优点：无痛、无创、无损。现就rTMS对GAD的临床和基础研究最新动态进行综述。
Keywords
广泛性焦虑障碍；重复经颅磁刺激；研究进展
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[23] AlexandroM,Rosa,Marina,et al. Transcranial magnetic stimulation:review of accidental seizures.[J].Revista brasile ira de psiquiatria (Sao Paulo,Brazil:1999),2004,26(2):131-134.
[2] Heller W, Nitschke J B, Etienne M A, et al. Patterns of regional brain activity differentiate types of anxiety[J]. Journal of abnormal psychology,1997,106(3):376.
[3] Machado S, Paes F, Velasques B, et al. Is rTMS an eff ective therapeutic strategy that can be used to treat anxiety disorders?[J]. Neuropharmacology,2012,62(1):125-134.
[4] 李越,王玉平,詹淑琴,等.重复经颅磁刺激治疗广泛性焦虑的对照研究[J].脑与神经疾病杂志,2012,20(2):84-88.
[5] Lu R,Zhang C,Liu Y, et al. The effect of bilateral low-frequency rTMS over dorsolateral prefrontal cortex on serum brain-derived neurotropic factor and serotonin in patients with generalized anxiety disorder[J]. Neuroscience Letters,2018,684:67-71.
[6] 陆如蓝,张成亮,周先举.重复经颅磁刺激治疗焦虑相关障碍研究进展[J].中国神经精神疾病杂志,2018,44(9):570-573.
[7] 陈琪,徐乐平,李宁,等.重复经颅磁刺激对焦虑症患者血清脑源性神经生长因子和γ-氨基丁酸浓度的影响[J].精神医学杂志,2018,31(3):185-187.
[8] Rossi,S,Hallett,et al.Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research[J].CLI NICAL NEUROPHYSIOLOGY -SHANNON-,2009,120:2008-39.
[9] Rodriguezmartin J L,Barbanoj J M,Schlaepfer T,et al. Transcranial magnetic stimulation(TMS)for depression[J]. John Wiley and Sons, Ltd. for The Cochrane Collaboration,2009,4:34-40.
[10] 李丽君,胡卫疆,高雅坤,等.重复经颅磁刺激治疗广泛性焦虑障碍的疗效及不良反应的meta分析[J].中华行为医学与脑科学杂志,2016,25(07):662-666.
[11] Huang Z,Li Y,Bianchi M T,et al.Repetitive transcranial magnetic stimulation of the right parietal cortex for comorbid generalized anxiety disorder and insomnia: a rand omized, double-blind, sham-controlled pilot study[J]. Brain stimulation,2018,11(5):1103-1109.
[12] 孙雪,方洁,陶晟,等.低频重复经颅磁刺激治疗广泛性焦虑疗效及对生活质量的影响[J].国际医药卫生导报,2021,27(1):53-56.
[13] 翟晓艳,刘敬,倪爱华.重复经颅磁刺激在广泛性焦虑障碍治疗中的效果评价[J].临床医药文献电子杂志,2017,4(91):17907-17908.
[14] 刘思琴,李春阳,杨子民,等.坦度螺酮联合重复经颅磁刺激治疗广泛性焦虑障碍疗效及对患者生活质量的影响[J].临床心身疾病杂志,2020,26(03):82-85.
[15] 刘志鹏,伍海林,胡茂荣,等.重复经颅磁刺激联合艾司西酞普兰治疗广泛性焦虑障碍的随机对照研究[J].江西医药,2019,54(3):212-214.
[16] 吴慧玲,胡茂荣,余斌,等.重复经颅磁刺激联合文拉法辛及劳拉西泮治疗广泛性焦虑[J].上海精神医学,2016,28(4):212-217.
[17] 徐彩霞,汤超华,俞洋,等.高频rTMS联合度洛西汀对青年首发广泛性焦虑障碍的疗效及认知功能的影响[J].四川精神卫生,2020,33(4):326-329.
[18] 翟绍征,易国萍,廖波,等.重复经颅磁刺激联合艾司西酞普兰治疗老年广泛性焦虑障碍的疗效[J].当代医学,2017,23(19):119-120.
[19] 何秀贞,夏韵妍,邓淑芳,等.低频重复经颅磁刺激合并艾司西酞普兰治疗老年广泛性焦虑障碍的对照研究[J].黑龙江中医药,2019,48(03):27-29.
[20] 伍晓凡,刘立志,梁学军.低频重复经颅磁刺激联合咪氮平治疗广泛性焦虑障碍的临床对照研究 [J].实用医药杂志,2016,33(12):1064-1066.
[21] 刘志鹏,伍海林,胡茂荣,等.重复经颅磁刺激联合艾司西酞普兰治疗广泛性焦虑障碍的随机对照研究 [J].江西医药,2019,54(03):212-214.
[22] 李旭娟,蔡巍.经颅磁刺激在精神疾病治疗中的应用[J].中华行为医学与脑科学杂志,2007,16(9):861-862.
[23] AlexandroM,Rosa,Marina,et al. Transcranial magnetic stimulation:review of accidental seizures.[J].Revista brasile ira de psiquiatria (Sao Paulo,Brazil:1999),2004,26(2):131-134.
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