重复经颅磁刺激治疗卒中后抑郁的研究进展

Advances in Research of Repetitive Transcranial Magnetic Stimulation for Post-Stroke Depression

卒中后抑郁(Post Stroke Depression, PSD)为神经功能缺损后所致的以持久且显著的心境低落为主,可伴有睡眠障碍、焦虑、心境改变、认知障碍等一系列临床表现的疾病,可直接影响患者神经康复和精神心理稳定,抑郁改变严重增加卒中后患者的住院率、致残率以及死亡率。常规主要为抗抑郁药物治疗,以及心理治疗等辅助手段,但抗抑郁药有时对PSD患者获益较小或无效,甚者副作用等不利因素导致疾病发展恶化。近年来,重复经颅磁刺激(Repetitive transcranial magnetic stimulation rTMS)以其副作用少、疗效可观备受欢迎,不少作者将此技术应用于卒中后抑郁的治疗,以求最低的弊端促使患者最大获益。通过查阅文献后发现此治疗手段众家见解各有千秋。为此,本文主要对rTMS治疗卒中后抑郁及伴随各临床症状展开综述,分析其治疗的研究进展,为临床工作起到可能性提示作用。

Post Stroke Depression(PSD)is along-term and significant depression caused by neurological deficits.It can beaccompanied by a series of clinical manifestations such as sleep disorders,anxiety,mood changes,and cognitive disorders.It can directly affect the patient'sneurological rehabilitation and mental and psychological stability.Depressionchanges severely increase the hospitalization rate,disability rate andmortality rate of patients after stroke.Routines are mainly anti-depressantmedications,as well as psychotherapy and other ancillary means,but antidepressantssometimes benefit less or ineffective PSD patients,and even side effects suchas side effects lead to disease progression.In recent years,Repetitivetranscranial magnetic stimulation(TMS)has been popular in a state with fewside effects and considerable curative effect.Many authors have applied thistechnique to the treatment of post-stroke depression in order to minimize thedrawbacks that the patients are the biggest Benefit.After consulting theliterature,it was found that this treatment has its own opinions.To this end,this article mainly reviews rTMS treatment of post-stroke depression and accompanyingvarious clinical symptoms,analyzes the research progress of its treatment,andplays a role in suggesting clinical work.