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重复经颅磁刺激对伴有自杀观念抑郁症的治疗效果研究进展
王 琦1, 杨 松2, 张云淑1, 栗克清1
1.河北省第六人民医院 睡眠医学科,河北 保定 071000;2.河北大学 医学院,河北 保定 071000
摘要:
抑郁症是以情感,认知和躯体症状为主的精神障碍。重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)广泛应用于抑郁症的临床治疗当中,但对于自杀观念的改善作用尚未得到一致性结果。关于rTMS的治疗效果尚未得到统一的原因,很多研究认为与目前抑郁症病因学研究尚未明确有关。抑郁症作为一种神经精神疾病,与诸多脑区存在广泛关联,各个脑区又相互连接发挥作用,其中默认网络、情感网络、突显网络、其他皮质边缘网络以及认知控制网络视为当今的研究热点。目前认为rTMS通过刺激大脑皮层,通过脑网络中各种通路作为媒介对深层的脑区发挥治疗作用,引起目标脑区的活动性改变从而治疗抑郁症,但是究竟目标脑区应如何选取成为一大难题,本文从抑郁症脑网络发病机制与rTMS对于脑网络方面的影响分析rTMS对伴有自杀观念抑郁症患者的治疗效果,为改善抑郁症患者自杀观念提供新的参考。
关键词:  抑郁症  自杀观念  重复经颅磁刺激  脑网络
DOI:10.11724/jdmu.2019.04.14
分类号:R749.059
基金项目:基金项目:政府资助省级临床医学优秀人才培养项目 (361014)
Research progress of repetitive transcranial magnetic stimulation in treatment of depression with suicidal ideation
WANG Qi1, YANG Song2, ZHANG Yunshu1, LI Keqing1
1.Sleep Medicine Department, the Sixth People's Hospital of Hebei, Baoding 071000, China;2.Medical College, Hebei University,Baoding 071000, China
Abstract:
Depression is a mental disorder dominated by emotional, cognitive and somatic symptoms. It has the characteristics of high incidence, high recurrence rate and high risk of suicide. It brings heavy burden to patients' families and society. Repetitive Transcranial Magnetic Stimulation (rTMS) has been widely used as an adjuvant therapy for depression in clinical treatment, but its effect on improving suicidal ideation has not been consistent. As for the reason why the therapeutic effect of rTMS has not been unified, more and more studies have shown that it is closely related to the etiology of depression. Depression, as a neuropsychiatric disease, is widely associated with many brain regions, and each brain region plays a role in interconnection. Among them, default network, emotional network, other cortical marginal network of prominence network and cognition play important roles. Control network is regarded as a research hotspot nowadays. At present, it is believed that rTMS can treat depression by stimulating the cerebral cortex and acting as a medium through various pathways in the brain network, causing the activity change of the target brain area. However, how to select the target brain area becomes a big problem. This paper discusses the influence of rTMS on the brain network from the pathogenesis of depression and the influence of rTMS on the brain network in order to provide a new reference for improving the suicide concept of depression patients.
Key words:  depression  suicide concept  repeated transcranial magnetic stimulation (rTMS)  brain network