Repetitive Transcranial Magnetic Stimulation (rTMS) in the treatment of Panic Disorder (PD) with comorbid major depression

被引:48
作者
Mantovani, Antonio
Lisanby, Sarah H.
Pieraccini, Fulvio
Ulivelli, Monica
Castrogiovanni, Paolo
Rossi, Simone
机构
[1] Columbia Univ, New York State Psychiat Inst, Dept Psychiat, Div Brain Stimulat & Therapeut Modulat, New York, NY 10032 USA
[2] Univ Siena, Sch Appl Neurol Sci, Dept Neurosci, I-53100 Siena, Italy
[3] Univ Siena, Dept Neurosci, Div Psychiat, I-53100 Siena, Italy
[4] Univ Siena, Dept Neurosci, Div Neurol, I-53100 Siena, Italy
关键词
repetitive Transcranial magnetic stimulation (rTMS); resting motor threshold; panic disorder (PD); major depressive disorder (MDD);
D O I
10.1016/j.jad.2006.11.027
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Studies suggest that the dorsolateral prefrontal cortex (DLPFC) participates in neural circuitry that is dysregulated in Panic Disorder (PD) and Major Depressive Disorder (MDD). We tested whether low-frequency repetitive Transcranial Magnetic Stimulation (rTMS) could normalize the overactivity of right frontal regions and thereby improve symptoms. Methods: Six patients with PD and comorbid MDD were treated with daily active 1-Hz rTMS to the right DLPFC for 2 weeks in this open-label trial. Results: Clinical improvements were apparent as early as the first week of treatment. After the second week, 5/6 of patients showed improvements in panic and anxiety, and 4/6 showed a decrease in depression, with sustained improvement at 6 months of follow-up. Right hemisphere resting motor threshold increased significantly after rTMS. Limitations: Limitations of this study are the open design and the small sample size. Conclusions: Slow rTMS to the right DLPFC resulted in significant clinical improvement and reduction of ipsilateral motor cortex excitability. Replications in larger sample will help to clarify the relevance of this preliminary data and to define the potential role of right DLPFC rTMS in panic with major depression. (c) 2007 Elsevier B.V. All rights reserved.
引用
收藏
页码:277 / 280
页数:4
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