磁刺激
心理信息
背景(考古学)
多药
随机对照试验
医学
萧条(经济学)
临床试验
脑刺激
难治性抑郁症
梅德林
心理学
物理医学与康复
精神科
重性抑郁障碍
认知
内科学
刺激
宏观经济学
古生物学
经济
法学
生物
政治学
作者
Davide Cappon,Tim den Boer,Caleb Jordan,Wanting Yu,Eran D. Metzger,Álvaro Pascual‐Leone
标识
DOI:10.1016/j.arr.2021.101531
摘要
The prevalence of treatment-resistant geriatric depression (GD) highlights the need for treatments that preserve cognitive functions and recognize polypharmacy in elderly, yet effectively reduce symptom burden. Transcranial magnetic stimulation (TMS) is a proven intervention for treatment-resistant depression in younger adults but the efficacy of TMS to treat depressed older adults is still unclear. This review provides an updated view on the efficacy of TMS treatment for GD, discusses methodological differences between trials in TMS application, and explores avenues for optimization of TMS treatment in the context of the ageing brain.A systematic review was conducted to identify published literature on the antidepressant efficacy of TMS for GD. Databases PubMed, Embase, and PsycINFO were searched for English language articles in peer-reviewed journals in March 2021.Seven randomized controlled trials (RCTs) (total n = 260, active n = 148, control n = 112) and seven uncontrolled trials (total n = 160) were included. Overall, we found substantial variability in the clinical response, ranging from 6.7% to 54.3%.The reviewed literature highlights large heterogeneity among studies both in terms of the employed TMS dosage and the observed clinical efficacy. This highlights the need for optimizing TMS dosage by recognizing the unique clinical features of GD. We showcase a set of novel approaches for the optimization of the TMS protocol for depression and discuss the possibility for a standardized TMS protocol tailored for the treatment of GD.
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