Impendulo efanelekile yokuzibandakanya ocansini oluphoqelelayo ku-Transcranial Magnetic Stimulation (2020)

2020 Jan 9; 22 (1). pii: 19l02469. doi: 10.4088 / PCC.19l02469.
I-Blum AW1, Nikeza uJ2,1.
I-PMID: 31930785
I-DOI: 10.4088 / PCC.19l02469

Ukuziphatha kocansi okuphoqelekile (CSB) kungukuphazamisa okhubazekile, okuholela ekuphazanyisweni kwengqondo, izinkinga zezezimali nezomndeni, kanye namanani aphakeme ezifo ezithathelwana ngocansi. Ukwelashwa kwamanje kwe-CSB akunasisekelo sobufakazi obuqinile futhi ukwenza izingqinamba ezinzima kuvame ukuba nzima ukufinyelela.1 Yize kungathenjwa ovivinyweni olukhulu, i-transcranial magnetic stimulation (TMS) inganikeza ukwelashwa okusebenzayo kwe-CSB. Ngaphezu kwalokho, ngokuqondisa ngokukhethekile imijikelezo ethile ye-neural, i-TMS ingahlinzeka ngemininingwane ebalulekile mayelana nezindawo zobuchopho ezifakwe ku-pathophysiology yokuziphatha okunobunzima kwezocansi. Silethula udaba lwe-CSB oluphendule kwi-TMS ejulile ye-cterex cterex ye-anterior.

Umbiko wezehlakalo

UMnu A wayeyindoda eneminyaka engama-34 ubudala ene-CSB futhi eyenzeka i-Obsessive-activive disorder (OCD). I-CSB yakhe ibonakala ngokusetshenziswa ngokweqile kwezithombe zocansi kanye nokushaya indlwabu okuphoqayo, okuholele ekulimaleni okukhulu ekusebenzeni, kufaka phakathi ukulahlekelwa ngumsebenzi. Ukuxilongwa kwe-CSB kwaqinisekiswa kusetshenziswa i-Minnesota Impulse Disways Interview.2 Ngaphambi kokuthola i-TMS, isikolo sikaMnu A ku-Yale-Brown Obsessive-Compulsive Scale sashintshwa kwa-CSB (CSB-YBOCS)3 yayineminyaka engama-23, ihambisana nokuqina kokugula okulinganiselayo. Wayephathwe ngedosi ezinzile ye-fluoxetine (40 mg nsuku zonke) ye-OCD ngosizo olunqunyelwe kusuka ku-CSB noma OCD yakhe. Umuthi wakhe wemithi awushintshiwe ngesikhathi sokulashwa.

Ngemuva kokuhlinzeka ngemvume enolwazi, uMnu A wathola amaseshini angama-28 we-TMS ejulile (ngaphezu kwamaviki ayi-6) ebheke ku-cortex cortex (ACC) engaphandle kwangaphandle esebenzisa ithuluzi leBrainsway Deep TMS eline-H7-coil (iBrainsway Ltd, iTel-Aviv, Israel ). UMnu uveze ukwehla okungu-39% kwezimpawu ze-CSB esikhathini esingamaviki ayi-6 (isikolo sakhe sokubeletha se-CSB-YBOCS sasingu-14, okuhambisana nokugula okuthe xaxa). Izimpawu zakhe zizonke ze-OCD zibuye zathuthuka kusuka ekusekelweni kwesisekelo ngemuva kwe-TMS (i-pretreatment YBOCS isikolo = 35, i-posttreatment YBOCS amaphuzu = 13). UMnu A nabahloli bebengaboni ukuthi uyaluthola yini usizo olusebenzayo noma lwe-sham. Ubike ukuthi akukho miphumela emibi ehlobene nokwelashwa. Zonke izinqubo zivunyelwe yibhodi yokubuyekezwa yesikhungo.

Ingxoxo

Leli cala libonisa ukuthi i-TMS ejulile eqonde ku-ACC ingaba ukwelashwa okusebenzayo kwe-CSB. Lokhu okutholakele kuhambisana nophando olusebenzayo lwe-neuroimaging olusebenzise i-ACC ku-CSB ngokubonisa ukuthi amadoda ane-CSB akhombise ukwenziwa ku-ACC okukhulu ukuphendula izinkomba zocansi (ie, izithombe zocansi) kunamadoda angenayo i-CSB.4 Kungenzeka futhi ukuthi i-TMS ejulile ye-ACC ingahle iholele ekushintsheni okungaqondile kwezinye izindawo ze-neural ezixhumana ne-ACC. Yize izindlela zezinga lesekethe zingaqondakali, lokhu okutholakele kusikisela ukuthi i-TMS ejulile ingamele inketho yokwelapha ethembisayo ye-CSB. Ukuthuthuka kulesi siguli kubonakale kuhambelana nezinguquko ekushayweni kobukhulu bophawu lwe-OCD. Ucwaningo olwengeziwe luyadingeka ukuze kuqinisekiswe lokhu okutholakele kanye nokuhlola isisekelo sabo semvelo.

IZINDAWO ZOLWAZI

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