Transkranijalna magnetska stimulacija u psihijatriji

master's thesis

• Title (english): Transcranial magnetic stimulation in psychiatry
• Author: Mihovil Megla
• Mentor: Neven Henigsberg (mentor)
• Committee member: Miroslav Herceg (predsjednik povjerenstva)
• Committee member: Dražen Begić (član povjerenstva)
• Committee member: Neven Henigsberg (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Psychiatry and Psychological Medicine); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Psychiatry

Abstract

Transkranijalna magnetska stimulacija (TMS) neinvazivna je metoda stimulacije moždanih struktura u svrhu postizanja terapijskih učinaka u raznim poremećajima. Postoje razne tehnike izvođenja i podtipovi TMS-a, a za psihijatriju najbitniji i najistraženiji protokoli su: protokol visoke frekvencije rTMS-a (HF rTMS) koji se primjenjuje na lijevi dorzolateralni prefrontalni korteks (DLPFC), protokol niske frekvencije rTMS-a (LF rTMS) koji se primjenjuje na desnom DLPFC-u te bilateralni HF/LF rTMS koji se koriste u terapiji depresije rezistentne na terapiju (TRD). Od ostalih indikacija za uporabu TMS-a valja izdvojiti posttraumatski stesni poremećaj, opsesivno-kompulzivni poremećaj, shizofreniju te nepsihijatrijske poremećaje u kojima djeluje analgetski (fibromijalgija, neuropatska bol) ili rehabilitacijski (oporavak motorike ruke u postakutnom moždanom udaru). Velika prednost TMS-a u usporedbi s ostalim neurostimulacijskim metodama su blage nuspojave i mogućnost izvođenja procedure bez uporabe anestezije, što znači da nema ni nuspojava anestezije kao ni troška vremena i novca za adekvatno obavljanje postupka pod anestezijom. Kontraindikacije za izvođenje pretrage su metalni objekti u tijelu pacijenta, a FDA preporučuje oprez u osoba s prijašnjom anamnezom epileptičkih napadaja iako sama pretraga veoma rijetko uzrokuje napadaje. FDA odobrava uporabu TMS za MDD od 2008., za migrenozne glavobolje od 2013., OKP od 2018., prestanak pušenja od 2020., te za anksioznu depresiju od 2021. godine.

Abstract (english)

Transcranial magnetic stimulation (TMS) is a non-invasive method of stimulation of the brain structures with the purpose of achieving therapeutic effects in various disorders. There are different tehniques and subtypes of TMS, but the most important and most researched protocols in psychiatry are: high-frequency rTMS protocol (HF rTMS) applied on the left dorsolateral prefrontal cortex (DLPFC), low-frequency rTMS protocol (LF rTMS) applied on the right dorsolateral prefrontal cortex (DLPFC) and bilateral HF/LF rTMS which are used in therapy of treatment-resistant depression (TRD). From other indications for TMS, one should point to post-traumtic stress disorder, obsessive-compulsive disorder, schizophrenia and non-psychiatric disorders in which it has analgetic effects (fibromyalgia, neuropathic pain) or rehabilitational effects (recovery of hand motorics in postacute stroke). TMS, in comparison with other neurostimulation methods, has a big advantage in its mild side-effects and the ability to perform the procedure without anesthesia, meaning there is no side-effects of anesthesia and there is no need for the time and money expense which adequate anesthesia requires. Contraindications for performing the procedure include metallic objects inside the patient's body, while the FDA recommends caution in persons with prior history of epileptic seizures even though the procedure very rarely causes seizures. FDA approves the use of TMS for MDD from 2008, for migraines from 2013, for OCD from 2018, smoking cessation from 2020 and for anxious depression from 2021.

• Keywords: transkranijalna magnetska stimulacija (TMS); depresija; PTSP; OKP; shizofrenija
• Keywords (english): transcranial magnetic stimulation (TMS); depression; PTSD; OCD; schizophrenia
• Language: croatian
• URN:NBN: urn:nbn:hr:105:426518
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-26 10:35:38