Fettsäurekonzentrationen bei depressiven Patienten im Verlauf einer repetitiven transkraniellen Magnetstimulation (rTMS)

Zusammenfassung

Bei Patienten mit depressiven Störungen werden Dysbalancen von Omega-3– und Omega-6-Fettsäuren (FS) diskutiert. Studienergebnisse wiesen einen antidepressiven Effekt einer repetitiven transkraniellen Magnetstimulation (rTMS) nach. Ziel unserer Studie war, die FS-Konzentrationen im Verlauf einer rTMS bei depressiven Patienten und Zusammenhänge zwischen Schweregrad der Depressivität und FS-Mustern zu ermitteln. Hierzu wurden 30 Patienten mit einer Depression in eine doppelblinde Plazebo-kontrollierte Studie eingeschlossen, erhielten entweder eine hochfrequente rTMS über dem linken, eine niedrigfrequente rTMS über dem rechten dorsolateralen präfrontalen Kortex oder eine Scheinbehandlung über einen Zeitraum von 10 Tagen. Vor und nach der Behandlungsserie wurden der Schweregrad der Depressivität, die psychomotorische Beeinträchtigung sowie die Serum-Konzentrationen der mehrfach ungesättigten FS analysiert. Während sich der Schweregrad der Depressivität in allen Gruppen besserte, war die psychomotorische Beeinträchtigung nur nach den realen rTMS-Formen rückläufig. Nach der hochfrequenten rTMS zeigte sich zusätzlich ein signifikanter Anstieg des FSQuotienten, während dies nach den anderen rTMS-Formen nicht der Fall war. Die Wertigkeit der FS-Konzentrationen als Marker für den Behandlungserfolg im Rahmen einer Depression wird diskutiert.

Summary

In depression a dysbalance of Omega-3– and Omega-6-fatty acids (FA) is discussed. Results of studies with repetitive transcranial magnetic stimulation (rTMS) showed an antidepressive efficacy. The aim of our study was to measure the FA-concentrations in depressive patients during a repetitive transcranial magnetic stimulation. Correlations between severity of depression and fatty acid concentrations were analyzed. 30 patients with depression were included in a double-blind, placebo-controlled study using two different real stimulation procedures. The patients received either an high frequency rTMS over left, a low frequency rTMS over right dorsolateral prefrontal cortex or a sham stimulation over 10 days. Severity of depression, psychomotor retardation and concentrations of FA were analyzed at baseline and after the rTMS treatment phase. Severity of depression was reduced in all groups. Regarding psychomotor retardation a significant reduction was evident after real rTMS. After high frequency rTMS a significant increase of the quotient of FA in comparison to the other kind of rTMS occurred. The valence of FA-concentrations as a marker for response to antidepressive treatment will be discussed.

Schlüsselwörter

Mehrfach ungesättigte Fettsäuren - repetitive transkranielle Magnetstimulation - Depression

Keywords

Polyunsaturated fatty acids - repetitive transcranial magneticstimulation - depression

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