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Srpski arhiv za celokupno lekarstvo
2014, vol. 142, br. 5-6, str. 280-285
jezik rada: srpski
vrsta rada: originalan članak
objavljeno: 10/05/2015
doi: 10.2298/SARH1406280J
Repetitivna transkranijalna magnetna stimulacija kao adjuvantna metoda u lečenju depresije - početna iskustva
aUniverzitet u Beogradu, Medicinski fakultet
bUniverzitet u Beogradu, Institut za medicinska istraživanja
cUniverzitet u Beogradu, Medicinski fakultet + Klinički centar Srbije, Klinika za psihijatriju, Beograd
dUniverzitet u Beogradu, Medicinski fakultet + Klinički centar Srbije, Klinika za neurologiju, Beograd

e-adresa: sasar@imi.bg.ac.rs

Projekat

Definisanje klastera molekulskih biomarkera za poboljšanu dijagnostiku i terapiju poremećaja raspoloženja (MPNTR - 41029)
Motorni i nemotorni simptomi parkinsonizma: kliničke, morfološke i molekularno-genetičke korelacije (MPNTR - 175090)

Sažetak

Repetitivna transkranijalna magnetna stimulacija (rTMS) je metoda moždane stimulacije koja se sve češće primenjuje u kliničkom i istraživačkom radu. Dosadašnja istraživanja su ukazala na moguće antidepresivno dejstvo rTMS, ali jasna nadmoćnost ove metode u odnosu na placebo još nije potvrđena. Cilj rada Cilj rada je bilo praćenje efekta rTMS kao adjuvantnog tretmana antidepresivima na jačinu depresivnosti tokom 18 nedelja primene protokola stimulacije. Metode rada Četiri bolesnika sa dijagnozom umerenog, odnosno teškog depresivnog poremećaja bila su uključena u studiju. Protokol je podrazumevao primenu 2.000 stimulacija na dan tokom 15 dana sa frekvencijom rTMS od 10 Hz, intenziteta 120% motornog praga, nad levim dorzolateralnim prefrontalnim korteksom. Subjektivni i objektivni simptomi depresije ocenjeni su pre početka primene rTMS i ponovo procenjeni u 3, 6, 12. i 18. nedelji od početka stimulacije. Rezultati Kod dva ispitanika je po završetku protokola rTMS uočeno povlačenje simptoma depresije koje se održalo tokom čitavog perioda nadgledanja. Kod jedne ispitanice zapažena je tendencija uspostavljanja remisije u prvih 12. nedelja kliničkog praćenja, ali je u 18. nedelji došlo do pojačanja simptoma depresije. Kod druge ispitanice nije zapaženo značajnije smanjenje simptoma depresije ni u jednom trenutku kliničkog praćenja. Zaključak Preliminarni rezultati ukazuju na dobru podnošljivost rTMS i efikasnost u pojačavanju delovanja antidepresiva, i to najpre kod epizoda depresije koje kraće traju i čiji su simptomi umerenog intenziteta.

Ključne reči

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