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پیشبینی کنندههای بالینی پاسخ به درمان تحریک مکرر مغناطیسی فراجمجمه ای (rTMS) در بیماران مبتلا به اختلال افسردگی | ||
فصلنامه پژوهشهای کاربردی روانشناختی | ||
مقاله 12، دوره 8، شماره 2، شهریور 1396، صفحه 181-200 اصل مقاله (1.31 M) | ||
نوع مقاله: مقاله پژوهشی | ||
شناسه دیجیتال (DOI): 10.22059/japr.2014.67577 | ||
نویسنده | ||
رضا رستمی* | ||
گروه آموزشی روانشناسی سلامت، دانشکده روانشناسی و علوم تربیتی، دانشگاه تهران | ||
چکیده | ||
تحریک مکرر مغناطیسی فراجمجمهای بر روی قشر پیش پیشانی رویکردی جدید در درمان بیماران مبتلا به افسردگی است. پاسخ به درمان rTMS در بیماران مبتلا به افسردگی متفاوت است. شناخت پیش بینی کننده های پاسخ به درمان، نقش مهمی در درمان بیماران مبتلا به افسردگی به وسیله rTMS دارد. هدف این مطالعه بررسی پیش بینی کنندههای جمعیت شناختی و بالینی پاسخ به درمان rTMS در بین بیماران مبتلا به افسردگی است. در یک مطالعه طبیعی گذشته نگر اطلاعات 092 نفر از بیماران مبتلا به اختلال افسردگی که در خرداد ماه 1141 الی دی ماه 1141 در مرکز علوم اعصاب بالینی آتیه جهت درمان افسردگی تحت تحریک مکرر مغناطیسی فراجمجمها ی قرار گرفتند، جمع آوری شد. از سه پروتکل رایج rTMS تحریک با فرکانس بالا، تحریک با فرکانس پایین و تحریک دوطرفه بر روی قشر پیش پیشانی پشتی جانبی برای درمان بیماران استفاده شده بود. همه بیماران 12 جلسه rTMS را سه روز در هفته به مدت یک ماه دریافت کرده بودند. پاسخ به درمان توسط مقیاس افسردگی ب BDI-II و کاهش 52 درصدی نمرات نسبت به خط پایه تعریف گردید. در تحلیل دادهها از روش رگرسیون لوجستیک استفاده شد. از 092 نفر، 112 نفر 9 درصد به درمان rTMS پاسخ دادند که از 42 نفر مبتلا به افسردگی تکقطبی 52 نفر 51 درصدو از 190 نفر مبتلا به افسردگی دوقطبی 62 نفر ) 90 درصد به درمان پاسخ دادند. در کل بیماران سن، بدبینی، احساس شکست، بیقراری، بیعلاقگی، بلاتصمیمی، تحریکپذیری و اشتغال ذهنی متغیرهای پیشبین پاسخ به درمان بودند. در بیماران تکقطبی بیعلاقگی، اشتغال ذهنی با نشانهها، فقدان انرژی و بیارزشی و در بیماران دوقطبی غمگینی، احساس شکست، خودانتقادی، بیقراری، بیعلاقگی، تغییر الگوی خواب و اشتغال ذهنی با نشانه های جسمی متغیرهای پیشبین پاسخ به درمان بودند. از پیشبینی کننده جمعیت شناختی سن و از پیشبینی کنندههای بالینی میتوان برای پیش بینی پاسخ به درمان rTMS استفاده کرد. | ||
کلیدواژهها | ||
پزشکی شخصی شده؛ پیشبینی کننده؛ تحریک مکرر مغناطیسی فراجمجمهای؛ افسردگی | ||
مراجع | ||
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