期刊
BRAZILIAN JOURNAL OF PSYCHIATRY
卷 41, 期 1, 页码 70-81出版社
ASSOC BRASILEIRA PSIQUIATRIA
DOI: 10.1590/1516-4446-2017-0018
关键词
Transcranial magnetic stimulation; transcranial direct current stimulation; mental disorders; major depressive disorder; review
类别
资金
- Coordenacao de Aperfeicaoamento de Pessoal de Nivel Superior (CAPES)/Alexander von Humboldt fellowship
- CAPES/the Institutos Nacionais de Ciencia e Tecnologia (INCT) program
- Associacao Beneficente Alzira Denise Hertzog da Silva
Objective: Noninvasive brain stimulation (NIBS) techniques, such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), are increasingly being used to treat mental disorders, particularly major depression. The aim of this comprehensive review is to summarize the main advances, limitations, and perspectives of the field. Methods: We searched PubMed and other databases from inception to July 2017 for articles, particularly systematic reviews and meta-analyses, evaluating the use of NIBS in psychiatric disorders. Results: We reviewed the mechanisms of action, safety, tolerability, efficacy, and relevant clinical parameters of NIBS. Repetitive TMS is already an established technique for the treatment of depression, and there is theoretically room for further methodological development towards a high-end therapeutic intervention. In contrast, tDCS is a technically easier method and therefore potentially suitable for wider clinical use. However the evidence of its antidepressant efficacy is less sound, and a recent study found tDCS to be inferior to antidepressant pharmacotherapy. Clinical trials using rTMS for other mental disorders produced mixed findings, whereas tDCS use has not been sufficiently appraised. Conclusion: The most promising results of NIBS have been obtained for depression. These techniques excel in safety and tolerability, although their efficacy still warrants improvement.
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