The Efficacy and Safety of Neuromodulation Treatments in Late-Life Depression.

Q1 Psychology Current Treatment Options in Psychiatry Pub Date : 2020-09-01 Epub Date: 2020-06-03 DOI:10.1007/s40501-020-00216-w

Sanne J H van Rooij, Patricio Riva-Posse, William M McDonald

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引用次数: 10

Abstract

Purpose of review: In this review, the efficacy and safety of FDA approved neuromodulation devices (electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) and vagus nerve stimulation (VNS)), as well as emerging neuromodulation treatments currently under investigation.

Recent findings: ECT is the "gold standard" somatic therapy for treatment resistant depression (TRD). Although the clinical benefits are outweighed by potential cognitive and cardiovascular side effects in majority of cases, it remains unfairly stigmatized. TMS has few cognitive or somatic side effects but is not as effective the treatment of psychotic depression or more treatment resistant depression in elders. VNS has limited data in older patients but has been shown to be effective in chronic, treatment resistant adults. Several investigative neuromodulation treatments including magnetic seizure therapy (MST), focal electrically administered seizure therapy (FEAST), transcutaneous VNS (tVNS), transcranial direct current stimulation (tDCS), and deep brain simulation (DBS) shown promise in geriatric TRD.

Summary: ECT, TMS and VNS are effective treatment for late-life depression, and research has continued to refine the techniques. Investigative neuromodulation techniques are promising, but evidence for the safety and efficacy of these devices in the geriatric population is needed.

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神经调节治疗老年抑郁症的疗效和安全性。

综述目的:在本综述中，FDA批准的神经调节装置(电惊厥治疗(ECT)，经颅磁刺激(TMS)和迷走神经刺激(VNS))的有效性和安全性，以及目前正在研究的新兴神经调节治疗方法。最近的研究发现:ECT是治疗难治性抑郁症(TRD)的“黄金标准”躯体疗法。尽管在大多数情况下，潜在的认知和心血管副作用超过了临床益处，但它仍然受到不公平的污名化。经颅磁刺激几乎没有认知或躯体方面的副作用，但在治疗精神病性抑郁症或老年人更难治疗的抑郁症方面效果不佳。VNS在老年患者中的数据有限，但已证明对慢性、治疗耐药的成年人有效。几种研究性神经调节治疗，包括磁发作治疗(MST)、局灶性电发作治疗(FEAST)、经皮VNS (tVNS)、经颅直流电刺激(tDCS)和深部脑模拟(DBS)，在老年TRD中显示出前景。总结:ECT、TMS和VNS是治疗老年抑郁症的有效方法，研究还在不断完善这些技术。调查性神经调节技术很有前途，但这些设备在老年人群中的安全性和有效性还需要证据。

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来源期刊

Current Treatment Options in Psychiatry Psychology-Clinical Psychology

CiteScore

5.70

自引率

0.00%

发文量

期刊介绍： This journal focuses on the latest advances in the multifaceted treatment of psychiatric disorders. Designed for physicians and other mental health professionals, Current Treatment Options in Psychiatry offers expert reviews on the management of a range of mental health conditions, includingSchizophrenia and other psychotic disordersSubstance use disordersAnxiety, obsessive-compulsive, and related disordersMood disordersEating and other impulse control disordersPersonality disordersArticles cover a range of established and emerging treatment options across the lifespan, and their innovative, hands-on format makes them ideal for informing treatment decisions at the point of care.We accomplish this by appointing leaders in the field to serve as Section Editors in key areas. Section Editors, in turn, select the most pressing topics as well as experts to present the latest research, assess the efficacy of available treatment options, and discuss special considerations.Additionally, an international Editorial Board—representing a range of disciplines within psychiatry and psychology—ensures that the journal content includes current, emerging research and suggests articles of special interest to their country or region.