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Nervenheilkunde 2005; 24(01): 48-58
DOI: 10.1055/s-0038-1629880
DOI: 10.1055/s-0038-1629880
Original Article
Repetitive Transkranielle Magnetstimulation
Konsensus zum therapeutischen Einsatz bei psychiatrischen ErkrankungenRepetetiv transcranial magnetic stimulationConsensus on the therapeutic use in psychiatric disordersAuthors
Further Information
Publication History
Eingegangen am:
09 March 2004
angenommen mit Revision am:
24 June 2004
Publication Date:
30 January 2018 (online)
Zusammenfassung
Die repetitive Transkranielle Magnetstimulation (rTMS) ist eine innovative Technologie, mit der nicht-invasiv neurobiologische, physiologische und psychologische Funktionen des Gehirns moduliert werden können. In Konferenzen deutscher TMS-Experten wurde, einem formalen Konsensusprozess folgend, das Nutzen/Risiko-Verhältnis der rTMS als therapeutische Technik für die Psychiatrie beurteilt. Die rTMS wurde als viel versprechendes und innovatives Verfahren beurteilt, dessen weitere Erforschung wünschenswert ist. Zurzeit erscheinen depressive Störungen unter der Vielzahl untersuchter Diagnosen als mögliche Hauptindikation einer rTMS-Behandlung. Die überwiegend medikamentös vorbehandelten und zum Teil therapieresistenten depressiven Patienten zeigten in den existierenden Studien ein positives Nutzen/Risiko-Profil im Sinne einer moderaten klinischen Verbesserung bei zugleich niedriger Nebenwirkungsrate. Die rTMS sollte grundsätzlich von in der Methode erfahrenen oder speziell ausgebildeten Ärzten durchgeführt werden. Die aktuellen Sicherheitsempfehlungen sind dabei zu berücksichtigen und ein engmaschiges Therapiemonitoring sollte erfolgen. Obwohl der wissenschaftliche Datenbestand zur rTMS stetig wächst, ist die Methode gegenwärtig noch als experimentelles Therapieverfahren einzuschätzen, das bislang noch weniger gut untersucht ist als vor einer Zulassung stehende Psychopharmaka.
Summary
Repetitive transcranial magnetic stimulation (rTMS) is a technology that allows non-invasive modulation of neurobiological, physiological and psychological functions. A conference of national rTMS experts in Germany has assessed benefit/risk aspects of rTMS as a therapeutic tool in psychiatry following a formal consensus process. rTMS has been rated as promising and innovative treatment technique, worth further exploration in controlled clinical settings. Depressive disorders appear to be the primary target for rTMS treatment within the variety of psychiatric disorders investigated to date. A moderate therapeutic efficacy together with few and modest side effects results in an overall positive benefit/risk ratio in the investigated pre-treated or treatmentresistant depressed patients. The clinical application of rTMS should be restricted to physicians experienced with rTMS or specially trained who follow safety guidelines and monitor patients closely. In spite of the growing body of evidence, rTMS is still an experimental technique and its efficacy and safety have been less substantially proven compared to pharmacological agents approved for the treatment of psychiatric disorders.
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