Neuromodulation approaches for the treatment of major depression: challenges and recommendations from a working group meeting

Arquivos de Neuro-Psiquiatria

André Russowsky Brunoni²  Chei Tung Teng²  Claudio Correa¹  Marta Imamura¹  Joaquim P Brasil-neto¹  Raphael Boechat¹  Moacyr Rosa¹  Paulo Caramelli¹  Roni Cohen¹  Jose Alberto Del Porto¹  Paulo Sergio Boggio¹  Felipe Fregni¹ 

[1] ,University of São Paulo Department and Institute of Psychiatry São Paulo SP ,Brazil

关键词: comprehensive review;    major depressive disorder;    ECT;    TMS;    clinical guidelines;    artigo de revisão;    transtorno depressivo maior;    eletroconvulsoterapia;    estimulação magnética transcraniana;    recomendações para a prática clínica;   

DOI  :  10.1590/S0004-282X2010000300021

来源: SciELO

【 摘 要 】

The use of neuromodulation as a treatment for major depressive disorder (MDD) has recently attracted renewed interest due to development of other non-pharmacological therapies besides electroconvulsive therapy (ECT) such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), and vagus nerve stimulation (VNS). METHOD: We convened a working group of researchers to discuss the updates and key challenges of neuromodulation use for the treatment of MDD. RESULTS: The state-of-art of neuromodulation techniques was reviewed and discussed in four sections: [1] epidemiology and pathophysiology of MDD; [2] a comprehensive overview of the neuromodulation techniques; [3] using neuromodulation techniques in MDD associated with non-psychiatric conditions; [4] the main challenges of neuromodulation research and alternatives to overcome them. DISCUSSION: ECT is the first-line treatment for severe depression. TMS and tDCS are strategies with a relative benign profile of side effects; however, while TMS effects are comparable to antidepressant drugs for treating MDD; further research is needed to establish the role of tDCS. DBS and VNS are invasive strategies with a possible role in treatment-resistant depression. In summary, MDD is a chronic and incapacitating condition with a high prevalence; therefore clinicians should consider all the treatment options including invasive and non-invasive neuromodulation approaches.

【 授权许可】

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