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Nervenheilkunde 2020; 39(04): 213-221
DOI: 10.1055/a-1113-0084
Schwerpunkt
© Georg Thieme Verlag KG Stuttgart · New York

Transkranielle Magnetstimulation zur Behandlung von Depressionen bei Schwangeren

Eine ÜbersichtTranscranial magnetic stimulation in the treatment of depression during pregnancyA review
Tobias Hebel
1   Klinik für Psychiatrie und Psychotherapie der Universität Regensburg
,
Martin Schecklmann∗
1   Klinik für Psychiatrie und Psychotherapie der Universität Regensburg
,
Berthold Langguth∗
1   Klinik für Psychiatrie und Psychotherapie der Universität Regensburg
› Author Affiliations
Further Information

Publication History

Publication Date:
02 April 2020 (online)

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Zusammenfassung

Gegenstand und Ziel In dieser Übersichtsarbeit sollen die Wirksamkeit und Sicherheit der repetitiven transkraniellen Magnetstimulation (rTMS) für die Patientengruppe depressiv erkrankter Schwangerer evaluiert werden.

Material und Methoden Es wurde eine Datenbankrecherche auf Pubmed durchgeführt, um alle relevanten Original- und Übersichtsarbeiten zu dem Thema zu identifizieren und zu analysieren

Ergebnisse Zusätzlich zu einer Reihe von Fallberichten existieren 3 kontrollierte Studien zur Behandlung depressiver Schwangerer mittels rTMS. Der Datenlage nach scheint die rTMS sowohl für die schwangeren Patientinnen als auch ihre ungeborenen Kinder sicher zu sein. Es wurden keine postnatalen negativen Wirkungen auf die Kindesentwicklung berichtet.

Schlussfolgerung rTMS stellt eine vielversprechende Behandlungsoption dar. Weitere Studien mit größeren Teilnehmerzahlen sind notwendig, um den Stellenwert der rTMS in einer multimodalen Depressionsbehandlung in der Schwangerschaft zu klären.

Abstract

Objective In this review, efficacy and safety of rTMS for the treatment of depressed pregnant patients shall be evaluated.

Material and methods A Pubmed database research was performed to identify and analyze original research and review articles relevant to the objective.

Results In addition to a number of case series, three controlled studies have been published on the treatment of depressed pregnant women with rTMS. Data indicates that rTMS seems to be safe for the pregnant patients and also their unborn children. No adverse postnatal effects on the offspring’s development have been reported.

Conclusion rTMS is a promising treatment option. Further studies with more participants are warranted to clarify the role of rTMS in a multimodal treatment of depression in pregnancy.

Schlüsselwörter

rTMS - TMS - Schwangerschaft - Pränatal

Key words

rTMS - TMS - pregnancy - prenatal
 

  • Literatur

  • 1 Raisanen S, Lehto SM, Nielsen HS. et al Risk factors for and perinatal outcomes of major depression during pregnancy: a population-based analysis during 2002–2010 in Finland. BMJ Open 2014; 4 (11) e004883
    CrossrefPubMedGoogle Scholar
  • 2 Becker M, Weinberger T, Chandy A. et al Depression During Pregnancy and Postpartum. Curr Psychiatry Rep 2016; 18 (03) 32
    CrossrefPubMedGoogle Scholar
  • 3 Ciesielski TH, Marsit CJ, Williams SM. Maternal psychiatric disease and epigenetic evidence suggest a common biology for poor fetal growth. BMC Pregnancy Childbirth 2015; 15: 192
    CrossrefPubMedGoogle Scholar
  • 4 Talge NM, Neal C, Glover V. Early Stress TR, Prevention Science Network F, Neonatal Experience on C et al Antenatal maternal stress and long-term effects on child neurodevelopment: how and why?. J Child Psychol Psychiatry 2007; 48 3–4 245-61
    CrossrefPubMedGoogle Scholar
  • 5 Nulman I, Koren G, Rovet J. et al Neurodevelopment of children prenatally exposed to selective reuptake inhibitor antidepressants: Toronto sibling study. J Clin Psychiatry 2015; 76 (07) e842-7
    CrossrefPubMedGoogle Scholar
  • 6 Hayes RM, Wu P, Shelton RC. et al Maternal antidepressant use and adverse outcomes: a cohort study of 228 876 pregnancies. Am J Obstet Gynecol 2012; 207 (01) 49e1-9
    CrossrefPubMedGoogle Scholar
  • 7 Bonari L, Koren G, Einarson TR. et al Use of antidepressants by pregnant women: evaluation of perception of risk, efficacy of evidence based counseling and determinants of decision making. Arch Womens Ment Health 2005; 8 (04) 214-20
    CrossrefPubMedGoogle Scholar
  • 8 Frank E, Eichhammer P, Burger J. et al Transcranial magnetic stimulation for the treatment of depression: feasibility and results under naturalistic conditions: a retrospective analysis. Eur Arch Psychiatry Clin Neurosci 2011; 261 (04) 261-6
    CrossrefPubMedGoogle Scholar
  • 9 Rossi S, Hallett M, Rossini PM. et al Safety of TMSCG. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol 2009; 120 (12) 2008-39
    CrossrefPubMedGoogle Scholar
  • 10 Kreuzer PM, Höppner J, Kammer T. et al rTMS in der Therapie psychiatrischer Erkrankungen. Nervenheilkunde 2015: 12
    PubMedGoogle Scholar
  • 11 Perera T, George MS, Grammer G, Janicak PG, Pascual-Leone A, Wirecki TS. The Clinical TMS Society Consensus Review and Treatment Recommendations for TMS Therapy for Major Depressive Disorder. Brain Stimul. 2016; 9 (03) 336-46
    CrossrefPubMedGoogle Scholar
  • 12 Lefaucheur JP, Andre-Obadia N, Antal A. et al Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clin Neurophysiol 2014; 125 (11) 2150-206
    CrossrefPubMedGoogle Scholar
  • 13 DGPPN S3-Leitlinie Unipolare Depression. Berlin: 2015
    Google Scholar
  • 14 Sehatzadeh S, Daskalakis ZJ, Yap B. et al Unilateral and bilateral repetitive transcranial magnetic stimulation for treatment-resistant depression: a meta-analysis of randomized controlled trials over 2 decades. J Psychiatry Neurosci 2019; 44 (02) 1-13
    Google Scholar
  • 15 Deng ZD, Lisanby SH, Peterchev AV. Electric field depth-focality tradeoff in transcranial magnetic stimulation: simulation comparison of 50 coil designs. Brain Stimul 2013; 6 (01) 1-13
    CrossrefPubMedGoogle Scholar
  • 16 Deng ZD, Lisanby SH, Peterchev AV. Coil design considerations for deep transcranial magnetic stimulation. Clin Neurophysiol 2014; 125 (06) 1202-12
    CrossrefPubMedGoogle Scholar
  • 17 Yanamadala J, Noetscher GM, Makarov SN. et al Estimates of peak electric fields induced by Transcranial magnetic stimulation in pregnant women as patients using an FEM full-body model. Conf Proc IEEE Eng Med Biol Soc 2017; 2017: 1441-4
    PubMedGoogle Scholar
  • 18 Kim DR, Epperson N, Pare E. et al An open label pilot study of transcranial magnetic stimulation for pregnant women with major depressive disorder. J Womens Health (Larchmt) 2011; 20 (02) 255-61
    CrossrefPubMedGoogle Scholar
  • 19 Kim DR, Wang E, McGeehan B. et al Randomized controlled trial of transcranial magnetic stimulation in pregnant women with major depressive disorder. Brain Stimul 2019; 12 (01) 96-102
    CrossrefPubMedGoogle Scholar
  • 20 Kim DR, Wang E. Prevention of supine hypotensive syndrome in pregnant women treated with transcranial magnetic stimulation. Psychiatry Res 2014; 218 1–2 247-8
    CrossrefPubMedGoogle Scholar
  • 21 Hizli Sayar G, Ozten E, Tufan E. et al Transcranial magnetic stimulation during pregnancy. Arch Womens Ment Health 2014; 17 (04) 311-5
    CrossrefPubMedGoogle Scholar
  • 22 Eryilmaz G, Sayar GH, Ozten E. et al Follow-up study of children whose mothers were treated with transcranial magnetic stimulation during pregnancy: preliminary results. Neuromodulation 2015; 18 (04) 255-60
    CrossrefPubMedGoogle Scholar
  • 23 Nahas Z, Bohning DE, Molloy MA. et al Safety and feasibility of repetitive transcranial magnetic stimulation in the treatment of anxious depression in pregnancy: a case report. J Clin Psychiatry 1999; 60 (01) 50-2
    CrossrefPubMedGoogle Scholar
  • 24 Klirova M, Novak T, Kopecek M. et al Repetitive transcranial magnetic stimulation (rTMS) in major depressive episode during pregnancy. Neuro Endocrinol Lett 2008; 29 (01) 69-70
    PubMedGoogle Scholar
  • 25 Tan O, Tarhan N, Coban A. et al Antidepressant Effect of 58 Sessions of rTMS in a Pregnant Woman With Recurrent Major Depressive Disorder: A Case Report. Prim Care Companion J Clin Psychiatry 2008; 10 (01) 69-71
    CrossrefPubMedGoogle Scholar
  • 26 Zhang D, Hu Z. RTMS may be a good choice for pregnant women with depression. Arch Womens Ment Health 2009; 12 (03) 189-90
    CrossrefPubMedGoogle Scholar
  • 27 Zhang X, Liu K, Sun J. et al Safety and feasibility of repetitive transcranial magnetic stimulation (rTMS) as a treatment for major depression during pregnancy. Arch Womens Ment Health 2010; 13 (04) 369-70
    CrossrefPubMedGoogle Scholar
  • 28 Gahr M, Blacha C, Connemann BJ. et al Successful treatment of major depression with electroconvulsive therapy in a pregnant patient with previous non-response to prefrontal rTMS. Pharmacopsychiatry 2012; 45 (02) 79-80
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 Burton C, Gill S, Clarke P. et al Maintaining remission of depression with repetitive transcranial magnetic stimulation during pregnancy: a case report. Arch Womens Ment Health 2014; 17 (03) 247-50
    CrossrefPubMedGoogle Scholar
  • 30 Ferrao YA, da Silva RMF. Repetitive transcranial magnetic stimulation for the treatment of major depression during pregnancy. Braz J Psychiatry 2018; 40 (02) 227-8
    CrossrefPubMedGoogle Scholar
  • 31 Xiong W, Lopez R, Cristancho P. Transcranial magnetic stimulation in the treatment of peripartum bipolar depression: a case report. Braz J Psychiatry 2018; 40 (03) 344-5
    CrossrefPubMedGoogle Scholar
  • 32 Trevizol AP, Vigod SN, Daskalakis ZJ. et al Intermittent theta burst stimulation for major depression during pregnancy. Brain Stimul 2019, ePub
    Google Scholar
  • 33 Blumberger DM, Vila-Rodriguez F, Thorpe KE. et al Effectiveness of theta burst versus high-frequency repetitive transcranial magnetic stimulation in patients with depression (THREE-D): a randomised non-inferiority trial. Lancet 2018; 391 10131 1683-92
    CrossrefPubMedGoogle Scholar
  • 34 Stubbeman WF, Zarrabi B, Bastea S. et al Bilateral neuronavigated 20 Hz theta burst TMS for treatment refractory depression: An open label study. Brain Stimul 2018; 11 (04) 953-5
    CrossrefPubMedGoogle Scholar
  • 35 Kim DR, Sockol L, Barber JP. et al A survey of patient acceptability of repetitive transcranial magnetic stimulation (TMS) during pregnancy. J Affect Disord 2011; 129 1–3 385-90
    CrossrefPubMedGoogle Scholar