Optimierung der repetitiven transkraniellen Magnetstimulation als Behandlung von Depressionen

E.-L. Brakemeier; A. Luborzewski; H. Danker-Hopfe; M. Bajbouj

doi:10.1055/s-0038-1626759

Nervenheilkunde, Table of Contents

Nervenheilkunde 2006; 25(08): 626-633
DOI: 10.1055/s-0038-1626759

Originaler Artikel

Schattauer GmbH

Optimierung der repetitiven transkraniellen Magnetstimulation als Behandlung von Depressionen

Welche Faktoren prädizieren ein Ansprechen?Optimizing prefrontal repetitive transcranial magnetic stimulation as a treatment for depressionWhich parameters predict a response?

Authors

E.-L. Brakemeier

¹Klinik und Hochschulambulanz für Psychiatrie and Psychotherapie, Charité – Universitätsmedizin Berlin (Leitung: Prof. Dr. I. Heuser)
A. Luborzewski

¹Klinik und Hochschulambulanz für Psychiatrie and Psychotherapie, Charité – Universitätsmedizin Berlin (Leitung: Prof. Dr. I. Heuser)
H. Danker-Hopfe

¹Klinik und Hochschulambulanz für Psychiatrie and Psychotherapie, Charité – Universitätsmedizin Berlin (Leitung: Prof. Dr. I. Heuser)
M. Bajbouj

¹Klinik und Hochschulambulanz für Psychiatrie and Psychotherapie, Charité – Universitätsmedizin Berlin (Leitung: Prof. Dr. I. Heuser)

Abstract

Zusammenfassung

Die rTMS gilt derzeit als mögliche Therapieoption für depressive Patienten, welche auf andere antidepressive Behandlungsverfahren nicht oder nur unzulänglich ansprechen. Die Datenlage zur Effektivität spricht insgesamt für eine moderate antidepressive Wirksamkeit der rTMS, allerdings ist die klinische Bedeutung der beobachteten Effekte eher gering, sodass Studien zur Optimierung der Effektivität von Nöten sind. In der Berliner Prädiktor Studie wurden mit der rTMS des linken DLPFC über einen Zeitraum von zwei Wochen 70 depressive Patienten behandelt, von denen 21% respondierten. Da insbesondere Einsicht in Veränderungen der individuellen klinischen Symptomcluster gewonnen werden sollte, wurden fünf Cluster im Verlauf analysiert. Durch regressionsanalytische Methoden konnte gezeigt werden, dass neben generellen Prädiktoren wie eine kurze Episodendauer und ein geringes Maß an Therapieresistenz, besonders motorische Retardierung und Schlafstörungen klinische Prädiktoren für ein Ansprechen auf rTMS sind.

Summary

rTMS is considered to be a putative treatment option for those depressive patients being refractory or intolerant to other antidepressant treatment forms. Overall, published studies show a significant reduction in depressive symptomatology due to rTMS, but the clinical significance of the therapeutic changes were only modest. Therefore, studies to optimize the efficacy of rTMS are necessary. In the Berlin Predictor Study rTMS treatment of the left dorsolateral prefrontal cortex was performed in 70 patients of whom 21% showed an antidepressant response. Since individual clinical symptom clusters were of special interest, five clusters are analyzed during course of the treatment. By usinga logistic regression model it could be shown that beside general predictors like short duration of episode and low level of therapy resistance, especially motor retardation and sleep disturbances are clinical predictors fora response to rTMS.

Schlüsselwörter

Repetitive transkranielle Magnetstimulation (rTMS) - Depression - Prädiktoren für Response

Keywords

Repetitive transcranial magnetic stimulation (rTMS) - major depressive disorder - response prediction

Full Text

References

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