作者: 盧偉信醫師
Dell’Osso, B. (Ed.). (2020). Non
Invasive Brain Stimulation in Psychiatry and Clinical Neurosciences.
Springer.
Cao, P., Wang, L., Cheng, Q., Sun, X., Kang, Q., Dai, L., Zhou, X., & Song, Z. (2019). Changes in serum miRNA-let-7 level in children with attention deficit hyperactivity disorder treated by repetitive transcranial magnetic stimulation or atomoxetine: An exploratory trial. Psychiatry research, 274, 189–194. https://doi.org/10.1016/j.psychres.2019.02.037
Alyagon, U., Shahar, H., Hadar, A.,
Barnea-Ygael, N., Lazarovits, A., Shalev, H., & Zangen, A. (2020).
Alleviation of ADHD symptoms by non-invasive right prefrontal stimulation is
correlated with EEG activity. NeuroImage. Clinical, 26,
102206. https://doi.org/10.1016/j.nicl.2020.102206
Bleich-Cohen, M., Gurevitch, G., Carmi, N.,
Medvedovsky, M., Bregman, N., Nevler, N., Elman, K., Ginou, A., Zangen, A.,
& Ash, E. L. (2021). A functional magnetic resonance imaging investigation
of prefrontal cortex deep transcranial magnetic stimulation efficacy in adults
with attention deficit/hyperactive disorder: A double blind, randomized
clinical trial. NeuroImage. Clinical, 30, 102670.
https://doi.org/10.1016/j.nicl.2021.102670
注意力不足過動症(ADHD)是一種神經發展疾患,主要症狀是注意力無法集中、容易忽略細節、粗心大意,很難保持安靜,容易衝動等等。
坊間常聽到反對ADHD治療的說法,認為只是一種多元性個人特質。但其實ADHD如未妥善治療可能嚴重影響個案之學業、人際關係及身心健康,是會影響一輩子發展的。現有ADHD藥物其實療效頗佳,安全性也高,不過當然治療選項是不嫌多的,而TMS也有針對ADHD的相關研究陸續進行中。TMS應用於兒童ADHD目前有兩個小型研究(其中之一有假線圈對照組),皆發現並無嚴重不良反應,且治療後ADHD各層面之症狀有明顯改善。成人ADHD則有兩個深度經顱磁刺激研究,發現經過15次治療後,跟假線圈相比,顯著改善注意力或整體症狀,且腦波或功能性磁振造影資料可預測治療效果。
整體來說,TMS應用於ADHD治療仍處於發展初期,仍需要更大型、有對照組及多中心的研究來進一步驗證其療效,以及效果能維持多久。臨床上因憂鬱症導致注意力不佳的患者,也經常能看到接受TMS治療後個案的專注力明顯改善,較能集中精神工作或從事日常活動。
參考資料:
Cao, P., Wang, L., Cheng, Q., Sun, X., Kang, Q., Dai, L., Zhou, X., & Song, Z. (2019). Changes in serum miRNA-let-7 level in children with attention deficit hyperactivity disorder treated by repetitive transcranial magnetic stimulation or atomoxetine: An exploratory trial. Psychiatry research, 274, 189–194. https://doi.org/10.1016/j.psychres.2019.02.037