Is theta burst stimulation ready as a clinical treatment for depression?

被引:20
作者
Chen, Leo [1 ,2 ,3 ]
Chung, Sung Wook [1 ]
Hoy, Kate E. [1 ,2 ]
Fitzgerald, Paul B. [1 ,2 ]
机构
[1] Monash Univ, Monash Alfred Psychiat Res Ctr, Level 4,607 St Kilda Rd, Melbourne, Vic 3004, Australia
[2] Epworth Hlth Care, Epworth Ctr Innovat Mental Hlth, Camberwell, Vic, Australia
[3] Alfred Hlth, Alfred Mental & Addict Hlth, Melbourne, Vic, Australia
基金
澳大利亚国家健康与医学研究理事会; 英国医学研究理事会;
关键词
Brain stimulation; depression; repetitive transcranial magnetic stimulation; theta burst stimulation; treatment resistant depression; TRANSCRANIAL MAGNETIC STIMULATION; DORSOLATERAL PREFRONTAL CORTEX; TREATING MAJOR DEPRESSION; NONINVASIVE BRAIN-STIMULATION; LONG-TERM POTENTIATION; ACCELERATED HF-RTMS; HIGH-FREQUENCY; DOUBLE-BLIND; CORTICAL EXCITABILITY; INTERINDIVIDUAL VARIABILITY;
D O I
10.1080/14737175.2019.1641084
中图分类号
R74 [神经病学与精神病学];
学科分类号
100204 [神经病学];
摘要
Introduction: Major depression is a common and debilitating mental disorder that can be difficult to treat. Substantive evidence over the past two decades has established repetitive transcranial magnetic stimulation (rTMS) as an effective antidepressant therapy, although scope exists to improve its efficacy and efficiency. Theta burst stimulation (TBS) is a novel rTMS pattern attracting much research interest as a tool to study neurophysiology and treat neuropsychiatric disorders. Areas covered: This article outlines rTMS' state of development and explores the physiology studies underpinning TBS development and its observable neuronal conditioning and metabolic effects. We present a systematic review of studies that applied TBS to treat depression, followed by commentary on safety and practical considerations. Expert opinion: Much experimental and clinical research have advanced our understanding of the antidepressant effects of TBS, although unanswered questions remain relating to its physiological effects, response variability and optimal parameters for therapeutic purposes. A small number of sham-controlled trials, and one large comparative trial, support the therapeutic efficacy of TBS and demonstrates its non-inferiority relative to traditional rTMS. In this light, TBS can reasonably be offered as an alternative to rTMS in treatment-resistant depression, while ongoing research is likely to inform its therapeutic potential.
引用
收藏
页码:1089 / 1102
页数:14
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