耳电针刺激迷走神经治疗难治性抑郁症的静息态fMRI和MRS初步研究
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摘要
抑郁症是一种常见的心境障碍,部分患者对抗抑郁药物治疗反应不佳,成为难治性抑郁症(TRD)。颈部手术植入式迷走神经刺激仪是TRD辅助的治疗技术,但耳电针刺激迷走神经治疗尚未应用到TRD的治疗中。对1例TRD患者采用耳电针刺激迷走神经治疗8周,临床症状明显改善;治疗前后fMRI扫描发现默认网络的功能连接增强。通过对该例TRD的分析,初步探讨耳电针刺激迷走神经治疗的临床有效性及潜在神经机制,以期为今后开展大样本临床试验提供依据。
引文
[1]李小娇,方继良.迷走神经刺激术治疗难治性抑郁症脑影像研究进展[J].中国神经精神疾病杂志,2018,44(4):242-245.
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[11] Price RB,Shungu DC,Mao X,et al. Amino acid neurotransmitters assessed by1H MRS:Relationship to treatment-resistance in major depressive disorder[J]. Biol Psychiatry,2009,65:792-800.
[2] Rush AJ,Trivedi MH,Wisniewski SR,et al. Acute and longerterm outcomes in depressed outpatients requiring one or several treatment steps:a STAR*D report[J]. Am J Psychiatry,2006,163:1905-1917.
[3] Sackeim HA. The definition and meaning of treatment-resistant depression[J]. Clin Psychiatry,2001,62:10-17.
[4] Conway CR,Chibnall JT,Gebara MA,et al. Association of cerebral metabolic activity changes with vagus nerve stimulation antidepressant response in treatment-resistant depression[J]. Brain Stimul,2013,6:788-797.
[5] Hein E,Nowak M,Kiess O,et al. Auricular transcutaneous electrical nerve stimulation in depressed patients:a randomized controlled pilot study[J]. Neural Transm,2013,120:821-827.
[6] Fang J,Rong P,Hong Y,et al. Transcutaneous vagus nervestimulation modulates default mode network in major depressive disorder[J]. Biol psychiatry,2016,79:266-273.
[7] Pizzagalli DA. Frontocingulate dysfunction in depression:toward biomarkers of treatment response[J]. Neuropsychopharmacology,2011,36:183-206.
[8] Umemoto A,HajiHosseini A,Yates ME,et al. Reward-based contextual learning supported by anterior cingulate cortex. Cogn Affect Behav[J]. Neurosci,2017,17:642-651.
[9] Fang J,Egorova N,Rong P,et al. Early cortical biomarkers of longitudinal transcutaneous vagus nerve stimulation treatment success in depression[J]. Neuroimage Clin,2016,14:105-111.
[10] de Kwaasteniet BP,Rive MM,RuhéHG,et al. Decreased resting-state connectivity between neurocognitive networks in treatment resistant depression[J]. Front Psychiatry,2015,6:28.
[11] Price RB,Shungu DC,Mao X,et al. Amino acid neurotransmitters assessed by1H MRS:Relationship to treatment-resistance in major depressive disorder[J]. Biol Psychiatry,2009,65:792-800.