Repetitive transcranial magnetic stimulation of the right parietal cortex for comorbid generalized anxiety disorder and insomnia: A randomized, double-blind, sham-controlled pilot study

被引:145
作者
Huang, Zhaoyang [1 ,2 ,4 ,5 ]
Li, Yue [1 ,2 ,3 ]
Bianchi, Matt T. [4 ]
Zhan, Shuqin [1 ,2 ]
Jiang, Fengying [1 ,2 ]
Li, Ning [1 ,2 ]
Ding, Yan [1 ,2 ]
Hou, Yue [1 ,2 ]
Wang, Li [1 ,2 ]
Ouyang, Quping [3 ]
Wang, Yuping [1 ,2 ]
机构
[1] Capital Med Univ, Xuanwu Hosp, Dept Neurol, Beijing 100053, Peoples R China
[2] Beijing Key Lab Neuromodulat, Beijing, Peoples R China
[3] Beijing Shunyi Hosp, Dept Neurol, Beijing, Peoples R China
[4] Massachusetts Gen Hosp, Dept Neurol, Boston, MA 02114 USA
[5] Harvard Med Sch, Div Sleep Med, Boston, MA USA
关键词
Generalized anxiety disorder; Insomnia; Repetitive transcranial magnetic stimulation; Right parietal cortex; Attentional bias; Emotion processing; COGNITIVE-BEHAVIOR THERAPY; FRONTAL EEG ASYMMETRY; FMRI-GUIDED RTMS; ATTENTIONAL BIAS; FUNCTIONAL CONNECTIVITY; DEPRESSIVE DISORDER; SPATIAL ATTENTION; MAJOR DEPRESSION; EMOTION; AMYGDALA;
D O I
10.1016/j.brs.2018.05.016
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
Background: Repetitive transcranial magnetic stimulation (rTMS) has been considered to be a promising technique for the treatment of neuropsychiatric disorders. However, little is known about the effectiveness of rTMS in the treatment of generalized anxiety disorder (GAD). Moreover, treatment data on comorbid GAD and insomnia remain lacking. The aim of this study was to examine the therapeutic effects of 1 Hz rTMS applied over the right parietal lobe on both anxiety and insomnia symptoms in patients with comorbid GAD and insomnia. Methods: 36 patients were randomized to either sham or active rTMS group (n = 18 each group). The rTMS was administered over the right posterior parietal cortex (P4 electrode site) at a frequency of 1 Hz and an intensity of 90% of the resting motor threshold. Results: Ten days of 1 Hz rTMS to the right parietal lobe significantly improved both anxiety and insomnia symptoms in the active group. Although the anxiety severity was not significantly correlated with insomnia severity at baseline, the improvement in the Hamilton Rating Scale for Anxiety (HRSA) scores were positively correlated with improvement in the Pittsburgh Sleep Quality Index (PSQI) scores. Conclusions: The present study is the first randomized sham-controlled study to assess the effectiveness of low frequency rTMS on the right parietal lobe in patients with comorbid GAD and insomnia. Our results suggested that 1 Hz low frequency rTMS administered over the parietal cortex is effective for both anxiety and insomnia symptoms in patients with comorbid GAD and insomnia. (C) 2018 Elsevier Inc. All rights reserved.
引用
收藏
页码:1103 / 1109
页数:7
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