{"id":4663,"date":"2022-03-01T16:51:27","date_gmt":"2022-03-01T08:51:27","guid":{"rendered":"http:\/\/web.csh.org.tw\/web\/cshmagazine\/?p=4663"},"modified":"2022-03-14T09:35:37","modified_gmt":"2022-03-14T01:35:37","slug":"%e9%87%8d%e8%a4%87%e6%80%a7%e9%80%8f%e9%a1%b1%e7%a3%81%e5%88%ba%e6%bf%80%e8%a1%93repetitive-transcranial-magnetic-stimulation-rtms","status":"publish","type":"post","link":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/?p=4663","title":{"rendered":"\u91cd\u8907\u6027\u900f\u9871\u78c1\u523a\u6fc0\u8853(Repetitive transcranial magnetic stimulation, rTMS)"},"content":{"rendered":"\n<p style=\"text-align:right\">\u8eab\u5fc3\u79d1\u3000\u8b1d\u660e\u9d3b\u91ab\u5e2b<\/p>\n\n\n\n<p>\u3000\u3000\u91cd\u8907\u6027\u900f\u9871\u78c1\u523a\u6fc0\u8853(Repetitivetranscranial magneticstimulation, rTMS) \u662f\u4e00\u7a2e\u975e\u4fb5\u5165\u6027\u7684\u6cbb\u7642\uff0c\u662f\u8fd1\u4f86\u65b0\u767c\u5c55\u6cbb\u7642\u6182\u9b31\u75c7\u7684\u65b9\u5f0f\u3002rTMS\u4f7f\u7528\u78c1\u8108\u885d\u53ca\u5f31\u96fb\u6d41\u6539\u8b8a\u5927\u8166\u76ae\u8cea\u795e\u7d93\u7d30\u80de\u52d5\u4f5c\u96fb\u4f4d\uff0c\u85c9\u4ee5\u6539\u8b8a\u523a\u6fc0\u4f4d\u7f6e\u8166\u5340\u8ff4\u8def\u7684\u6d3b\u6027\uff0c\u5c07\u904e\u9ad8\u6216\u904e\u4f4e\u7684\u8166\u5340\u8ff4\u8def\u6062\u5fa9\u6b63\u5e38\uff0c\u900f\u904e\u8166\u5340\u7db2\u7d61\u9023\u7d50\u53ef\u5f71\u97ff\u57fa\u5e95\u6838\u3001\u674f\u4ec1\u6838\u53ca\u6d77\u99ac\u8ff4\u7b49\u8207\u60c5\u7dd2\u6709\u95dc\u7684\u6df1\u5340\u8166\u8ff4\u3002\u65e9\u57282008\u5e74\u7f8e\u570b\u98df\u54c1\u85e5\u7269\u7ba1\u7406\u5c40(FDA)\u5373\u6838\u51c6\u7528rTMS\u6cbb\u7642\u6182\u9b31\u75c7\u3002<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignright is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/web.csh.org.tw\/web\/cshmagazine\/wp-content\/uploads\/2022\/02\/5703-07.jpg\" alt=\"\" class=\"wp-image-4664\" width=\"205\" height=\"344\"\/><figcaption>\u8eab\u5fc3\u79d1\u3000\u8b1d\u660e\u9d3b\u91ab\u5e2b<\/figcaption><\/figure><\/div>\n\n\n\n<p>\u53f0\u7063\u885b\u798f\u90e8\u65bc2018\u5e744\u6708\u901a\u904erTMS\u53ef\u6cbb\u7642\u7d93\u5169\u7a2e\u4ee5\u4e0a\u6297\u9b31\u5291\u6cbb\u7642\u4ecd\u7121\u6cd5\u5eb7\u5fa9\u7684\u300c\u96e3\u6cbb\u578b\u6182\u9b31\u75c7\u300d(Treatment resistant depression,TRD)\u6216\u7121\u6cd5\u627f\u53d7\u85e5\u7269\u526f\u4f5c\u7528\u7684\u6182\u9b31\u75c5\u4eba\u8005\u3002\u6cbb\u7642\u6642\u4f7f\u752810Hz rTMS\u523a\u6fc0\u5de6\u8166DLPFC, \u6bcf\u6b21\u6cbb\u764220\u5206\u9418\u5167\u65bd\u62533000\u767c\u523a\u6fc0\uff0c\u5171\u970020\u81f330\u6b21\u6cbb\u7642\u624d\u80fd\u898b\u6548\uff0c\u6cbb\u76424\u81f36\u9031\u7d04\u670930%\u96e3\u6cbb\u578b\u6182\u9b31\u75c7\u75c5\u4eba\u53ef\u7de9\u89e3\u3002\u7814\u7a76\u986f\u793a\u6182\u9b31\u75c5\u4eba\u7684\u5de6\u8166\u80cc\u5916\u5074\u524d\u984d\u8449\u76ae\u8cea(Dorsolateral prefrontal cortex, DLPFC)\u5e38\u6709\u529f\u80fd\u4f4e\u4e0b\u7684\u73fe\u8c61\uff0c\u8207\u5176\u76f8\u95dc\u7684\u8166\u90e8\u8ff4\u8def\u529f\u80fd\u4e5f\u8b8a\u5dee\uff0crTMS\u5c0d\u529f\u80fd\u4f4e\u4e0b\u7684\u8166\u5340\u7d66\u4e88\u523a\u6fc0\u8208\u596e\u800c\u6539\u5584\u6182\u9b31\u75c7\u72c0\u3002\u53e6\u5916\uff0c\u6182\u9b31\u75c7\u53f3\u8166DLPFC\u5e38\u51fa\u73fe\u529f\u80fd\u904e\u9ad8\u73fe\u8c61\uff0crTMS\u53ef\u6291\u5236\u8166\u5340\u8ff4\u8def\u800c\u6539\u5584\u6182\u9b31\u75c7\u72c0\u3002\u5176\u4ed6\u7814\u7a76\u4ea6\u986f\u793arTMS\u6cbb\u7642\u6182\u9b31\u75c7\u7684\u6a5f\u8f49\u4e0d\u50c5\u53ef\u8abf\u6574\u5927\u8166\u76ae\u8ceafrontocingulate circuit\uff0c\u4e14\u6703\u5f71\u97ff\u55ae\u80fa\u795e\u7d93\u50b3\u5c0e\u7269\u8cea\uff0c\u5982\u589e\u52a0\u524d\u984d\u8449\u76ae\u8cea\u7684\u03b3-aminobutyric acid\uff0crTMS\u4f5c\u7528\u5728\u5de6\u8166DLPFC\u53ef\u4ee5\u8abf\u7bc0tryptophan\/serotonin \u5728\u908a\u7de3\u7cfb\u7d71\u7684\u4ee3\u8b1d\uff0c\u800cintermittent theta-burst stimulation(iTBS)\u53ef\u4ee5\u8abf\u6574\u53f3\u524d\u5cf6\u8449(insula)\u7684\u529f\u80fd\u3002<\/p>\n\n\n\n<p>\u3000\u3000rTMS\u6cbb\u7642\u7684\u6a21\u5f0f\u5305\u62ec\u4f4e\u983b\u7387(1Hz)\u6216\u9ad8\u983b\u7387(10\u201320 Hz)\u3001\u55ae\u5074\u6216\u96d9\u5074\u523a\u6fc0\u3001intermittentthetaburst stimulation (iTBS)\u3001continuous thetaburst stimulation(cTBS)\u53cadeep TMS\u3002HF-rTMS(5\u201350 Hz)\u53caiTBS\u4f5c\u7528\u5728\u5de6\u8166DLPFC\uff0c\u53ef\u589e\u52a0\u5927\u8166\u76ae\u8cea\u8208\u596e\u6027\u800c\u6539\u5584\u6182\u9b31\u75c7\u72c0 ;LF-rTMS (1 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src=\"https:\/\/web.csh.org.tw\/web\/cshmagazine\/wp-content\/uploads\/2022\/02\/5703-08.jpg\" alt=\"\" class=\"wp-image-4667\" width=\"315\" height=\"244\"\/><\/figure><\/div>\n\n\n\n<p>\u7136\u800c\u65b0\u578bTBS\u7642\u6cd5\u7684\u81e8\u5e8a\u8b49\u64da\u4ecd\u5f85\u7d2f\u7a4d\u4e14\u9577\u671f\u6548\u679c\u4e5f\u4e0d\u5982rTMS\u660e\u78ba\uff0c\u56e0\u6b64\u9700\u8207\u91ab\u5e2b\u8a73\u7d30\u8a0e\u8ad6\u5f8c\u6c7a\u5b9a\u3002\u82e5\u75c5\u60a3\u982d\u9838\u90e8\u6216\u8eab\u9ad4\u6709\u91d1\u5c6c\u690d\u5165\u7269(\u5982\u4eba\u5de5\u96fb\u5b50\u8033\u6216\u5fc3\u5f8b\u8abf\u7bc0\u5668)\u3001\u7672\u7647\u75c5\u53f2\u3001\u9152\u766e\u3001\u6216\u8166\u90e8\u75c5\u8b8a(\u5982\u8840\u7ba1\u6027\u3001\u5275\u50b7\u3001\u8166\u7624\u3001\u611f\u67d3\u3001\u6216\u4ee3\u8b1d\u6027\u75be\u60a3)\u5247\u4e0d\u9069\u5408\u63a5\u53d7rTMS\uff0c\u61f7\u5b55\u6216\u6700\u8fd1\u6709\u56b4\u91cd\u5fc3\u81df\u75be\u75c5\u5247\u53ef\u80fd\u589e\u52a0\u4e0d\u78ba\u5b9a\u7684\u98a8\u96aa\u3002rTMS\u6709\u4e00\u500b\u975e\u5e38\u7f55\u898b\u7684\u526f\u4f5c\u7528\u662f\u5f15\u767c\u7672\u7647\u767c\u4f5c\uff0c\u591a\u6578\u7684\u539f\u56e0\u662f\u672a\u9075\u5faarTMS\u6cbb\u7642\u6307\u5f15\u7684\u64cd\u4f5c\u6240\u5c0e\u81f4\uff0c\u6216\u8005\u540c\u6642\u670d\u7528\u6703\u964d\u4f4e\u7672\u7647\u95be\u8cea\u7684\u85e5\u7269\u3002\u9664\u4e86\u6182\u9b31\u75c7\uff0c\u6b50\u7f8e\u5404\u570b\u4e5f\u6b63\u5728\u7814\u7a76\u5c07rTMS\u7528\u5728\u5f88\u591a\u75be\u75c5\u7684\u6cbb\u7642\uff0c\u5982\u795e\u7d93\u6027\u75bc\u75db\u3001\u5e15\u91d1\u68ee\u75be\u75c5\u3001\u8166\u4e2d\u98a8\u3001\u591a\u767c\u6027\u786c\u5316\u75c7\u3001\u7672\u7647\u3001\u5931\u667a\u75c7\u3001\u8f15\u5ea6\u8a8d\u77e5\u969c\u7919\u3001\u601d\u89ba\u5931\u8abf\u75c7\u3001\u9152\u766e\u3001\u85e5\u766e\u3001\u7159\u766e\u3001\u8ced\u535a\u6210\u766e\u3001\u7126\u616e\u75c7\u3001\u5275\u50b7\u5f8c\u58d3\u529b\u75c7\u5019\u7fa4\u3001\u5f37\u8feb\u75c7\u3001\u81ea\u9589\u75c7\u3001\u904e\u52d5\u75c7\u3001\u667a\u80fd\u969c\u7919\u3001\u98f2\u98df\u969c\u7919\u7b49\u75be\u75c5\uff0c\u76f8\u4fe1\u672a\u4f86\u5c07\u70ba\u6cbb\u7642\u5e36\u4f86\u66f4\u591a\u7684\u65b0\u9032\u5c55\uff01<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u8eab\u5fc3\u79d1\u3000\u8b1d\u660e\u9d3b\u91ab\u5e2b \u3000\u3000\u91cd\u8907\u6027\u900f\u9871\u78c1\u523a\u6fc0\u8853(Repetitivetranscranial magneticst [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[19],"tags":[123,184,187],"class_list":["post-4663","post","type-post","status-publish","format-standard","hentry","category-19","tag-123","tag-184","tag-187"],"_links":{"self":[{"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/posts\/4663"}],"collection":[{"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4663"}],"version-history":[{"count":2,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/posts\/4663\/revisions"}],"predecessor-version":[{"id":4668,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/posts\/4663\/revisions\/4668"}],"wp:attachment":[{"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4663"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4663"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4663"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}