Majör Depresif Bozukluk ve Obsesif-Kompulsif Bozukluğa Eşlik Eden Nikotin Bağımlılığında Tekrarlayan Transkraniyal Manyetik Stimülasyon (rTMS) Tedavisinin Etkileri

Yıl 2022, Cilt: 23 Sayı: 3, 275 - 282, 30.09.2022

Asena Uzdu Yaşar Buket Cinemre Ali Erdoğan

https://doi.org/10.51982/bagimli.1016942

Cited By: 2

Öz

Amaç: Psikiyatrik bozukluklarda nikotin bağımlılığı çok sık eşlik eden bir sağlık sorunudur. Bu çalışmanın amacı, majör depresif bozukluk (MDB) ve obsesif-kompulsif bozukluk (OKB) için tekrarlayan Transkraniyal Manyetik Stimülasyon (rTMS) tedavisi alan hastalarda, rTMS'nin komorbid nikotin bağımlılığı üzerindeki etkilerini analiz etmektir.
Yöntem: rTMS tedavisi alan 32 hastadan (23 MDB, 9 OKB) elde edilen verilere dayanan retrospektif bir kohort yaptık. Hamilton Depresyon Derecelendirme Ölçeği (HAM-D), Beck Anksiyete Envanteri (BAS), Yale-Brown Obsesyon Kompulsiyon Ölçeği (Y-BOCS) ve Fagerström Nikotin Bağımlılığı Testi (FTND) puanlarını üç zaman noktasında karşılaştırdık (tedaviden önce “0. hafta", tedavinin sonunda "6. hafta" ve bu değerlendirmeden 12 hafta sonra "18. hafta").
Bulgular: Hastaların yaş ortalaması 40,47±10,20, 13'ü (%40,6) kadındı. HAM-D, BAS, FTND'de 6. haftalarda (tümü için p<0,001) ve 18. haftada (tümü için p<0,001) başlangıç puanlarına göre anlamlı bir azalma bulundu. İkili bir lojistik regresyon, depresyon ve anksiyete semptomlarındaki değişikliklerin 6. ve 18. haftalarda FTND puanlarındaki değişikliklerle ilişkili olmadığını gösterdi (sırasıyla p=0.158, p=0.251).
Sonuç: Bu çalışmada rTMS tedavisinin psikiyatrik hastalığın iyileşmesinden bağımsız olarak MDB ve OKB'ye eşlik eden nikotin bağımlılığının şiddetini azalttığı söylenebilir. Bu çalışma, rTMS'nin psikiyatrik bozukluklarla birlikte görülen nikotin bağımlılığı için etkili bir tedavi olabileceğini düşündürmektedir. Plasebo kontrollü randomize çift kör çalışmaları öneriyoruz.

Anahtar Kelimeler

Nöromodülasyon, nikotin bağımlılığı, psikiyatrik bozukluklar, transkraniyal manyetik stimülasyon, rTMS

Destekleyen Kurum

YOK

Effects of Repetitive Transcranial Magnetic Stimulation (rTMS) Treatment in Comorbid Nicotine Addiction with Major Depressive Disorder and Obsessive-Compulsive Disorder

Öz

Objective: Nicotine addiction is a common health problem in psychiatric disorders. The aim of this study was to analyze the effects of rTMS on comorbid nicotine addiction in patients receiving recurrent Transcranial Magnetic Stimulation (rTMS) therapy for major depressive disorder (MDD) and obsessive-compulsive disorder (OCD).
Method: Data of 32 patients (23 MDD, 9 OCD) were evaluated retrospectively. We compared the Hamilton Depression Rating Scale (HAM-D), Beck Anxiety Inventory (BAS), Yale-Brown Obsession Compulsion Scale (Y-BOCS), and Fagerström Test for Nicotine Dependence (FTND) scores at three time points (before treatment "0th week", at the end of treatment “6th week”, and 12 weeks after this assessment “18th week”).
Results: The patients’ mean age was 40.47±10.20, 13(40.6%) were women. A significant reduction was found in HAM-D, BAS, FTND at weeks 6 (p<0.001 for all) and 18 (p<0.001 for all) compared to baseline scores. A binary logistic regression showed that changes in depression and anxiety symptoms were not associated with the changes in FTND ratings at weeks 6 and 18 (p=0.158, p=0.251, respectively).
Conclusion: In this study, it can be said that rTMS treatment reduces the severity of nicotine addiction accompanying MDD and OCD, independent of the recovery of the psychiatric disease. This study suggests that rTMS can be an effective treatment for nicotine addiction comorbid with psychiatric disorders. We recommend placebo-controlled randomized double-blind studies.

Anahtar Kelimeler

Neuromodulation, nicotine addiction, psychiatric disorders, transcranial magnetic stimulation, rTMS

Kaynakça

• Perez-Warnisher MT, Carballosa de Miguel MDP, Seijo LM. Tobacco use worldwide: legislative efforts to curb consumption. Ann Glob Health. 2019; 85(1): 9 .
• Babb S, Malarcher A, Schauer G, et al. Quitting smoking among adults - United States, 2000-2015. MMWR Morb Mortal Wkly Rep 2017; 65(52): 1457-1464.
• Creamer MR, Wang TW, Babb S, et al. Tobacco product use and cessation ındicators among adults - United States, 2018. MMWR Morb Mortal Wkly Rep 2019; 68(45): 1013-1019.
• Oliveira RM, Santos JLF, Furegato ARF. Prevalence and smokers' profile: comparisons between the psychiatric population and the general population. Rev Lat Am Enfermagem 2019; 27: e3149.
• Krieger I, Tzur Bitan D, Comaneshter D, et al. Increased risk of smoking-related illnesses in schizophrenia patients: a nationwide cohort study. Schizophr Res 2019; 212: 121-125.
• Pascual-Leone A, Valls-Solé J, Wassermann EM, Hallett M. Responses to rapid-rate transcranial magnetic stimulation of the human motor cortex. Brain 1994; 117(4): 847-858.
• Cooke SF, Bliss TV. Plasticity in the human central nervous system. Brain 2006; 129(7): 1659-1673.
• Ni Z, Chen R. Transcranial magnetic stimulation to understand pathophysiology and as potential treatment for neurodegenerative diseases. Transl Neurodegener 2015; 4: 22.
• Li X, Hartwell KJ, Owens M, et al. Repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex reduces nicotine cue craving. Biol Psychiatry 2013; 73(8): 714-720.
• Sheffer CE, Bickel WK, Brandon TH, et al. Preventing relapse to smoking with transcranial magnetic stimulation: Feasibility and potential efficacy. Drug Alcohol Depend 2018; 182: 8-18.
• Eichhammer P, Johann M, Kharraz A, et al. High-frequency repetitive transcranial magnetic stimulation decreases cigarette smoking. J Clin Psychiatry 2003; 64(8): 951-953.
• Huang W, Shen F, Zhang J, Xing B. Effect of repetitive transcranial magnetic stimulation on cigarette smoking in patients with schizophrenia. Shanghai Arch Psychiatry 2016; 28(6): 309-317.
• Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23(1): 56-62.
• Akdemir A, Örsel DS, Dağ İ, et al. Hamilton depresyon derecelendirme ölçeği (HDDÖ)'nin geçerliliği-güvenirliliği ve klinikte kullanımı. Psikiyatri Psikoloji Psikofarmakoloji Dergisi 1996; 4(4): 251-259.
• Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56(6): 893-897.
• Ulusoy M, Sahin NH, Erkmen H. Turkish version of the beck anxiety ınventory: psychometric properties. Journal of cognitive psychotherapy 1998; 12(2): 163.
• Goodman WK, Price LH, Rasmussen SA, et al. The Yale-Brown obsessive compulsive scale. II. validity. Arch Gen Psychiatry 1989; 46(11): 1012-1016.
• Tek C, Uluğ B, Rezaki BG, et al. Yale-Brown obsessive compulsive scale and us national ınstitute of mental health global obsessive compulsive scale in turkish: reliability and validity. Acta Psychiatr Scand 1995; 91(6): 410-413.
• Pomerleau CS, Carton SM, Lutzke ML, et al. Reliability of the fagerstrom tolerance questionnaire and the fagerstrom test for nicotine dependence. Addict Behav 1994; 19(1): 33-39.
• Uysal MA, Kadakal F, Karşidağ C, et al. Fagerstrom test for nicotine dependence: reliability in a Turkish sample and factor analysis. Tuberk Toraks 2004; 52(2): 115-121.
• Thornton LK, Baker AL, Lewin TJ, et al. Reasons for substance use among people with mental disorders. Addict Behav 2012; 37(4): 427-434.
• Abdelrahman AA, Noaman M, Fawzy M, et al. A double-blind randomized clinical trial of high frequency rTMS over the DLPFC on nicotine dependence, anxiety and depression. Sci Rep 2021; 11(1): 1640.
• Johann M, Wiegand R, Kharraz A, et al. Transkranielle magnetstimulation bei nikotinabhängigkeit [repetitiv transcranial magnetic stimulation in nicotine dependence]. Psychiatr Prax. 2003; 30(Suppl 2): 129-131.
• Song S, Zilverstand A, Gui W, et al. Effects of single-session versus multi-session non-invasive brain stimulation on craving and consumption in individuals with drug addiction, eating disorders or obesity: A meta-analysis. Brain Stimul 2019; 12(3): 606-618.
• Li X, Hartwell KJ, Henderson S, et al. Two weeks of image-guided left dorsolateral prefrontal cortex repetitive transcranial magnetic stimulation improves smoking cessation: A double-blind, sham-controlled, randomized clinical trial. Brain Stimul 2020; 13(5): 1271-1279.
• Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018) [published correction appears in Clin Neurophysiol. 2020 May;131(5):1168-1169]. Clin Neurophysiol 2020; 131(2): 474-528.
• Zhang JJQ, Fong KNK, Ouyang RG, Siu AMH, Kranz GS. Effects of repetitive transcranial magnetic stimulation (rTMS) on craving and substance consumption in patients with substance dependence: a systematic review and meta-analysis. Addiction 2019; 114(12): 2137-2149.
• Berlim MT, van den Eynde F, Tovar-Perdomo S, Daskalakis ZJ. Response, remission and drop-out rates following high-frequency repetitive transcranial magnetic stimulation (rTMS) for treating major depression: a systematic review and meta-analysis of randomized, double-blind and sham-controlled trials. Psychol Med 2014; 44(2): 225-239.
• Gellersen HM, Kedzior KK. Antidepressant outcomes of high-frequency repetitive transcranial magnetic stimulation (rTMS) with F8-coil and deep transcranial magnetic stimulation (DTMS) with H1-coil in major depression: a systematic review and meta-analysis. BMC Psychiatry 2019; 19(1): 139.
• Senova S, Cotovio G, Pascual-Leone A, Oliveira-Maia AJ. Durability of antidepressant response to repetitive transcranial magnetic stimulation: Systematic review and meta-analysis. Brain Stimul 2019; 12(1): 119-128.
• Berlim MT, Van Den Eynde F. Repetitive transcranial magnetic stimulation over the dorsolateral prefrontal cortex for treating posttraumatic stress disorder: an exploratory meta-analysis of randomized, double-blind and sham-controlled trials. Can J Psychiatry 2014; 59(9): 487-496.
• Elbeh KAM, Elserogy YMB, Khalifa HE, et al. Repetitive transcranial magnetic stimulation in the treatment of obsessive-compulsive disorders: Double blind randomized clinical trial. Psychiatry Res 2016; 238: 264-269.
• Caulfield KA, Stern AP. Therapeutic high-frequency repetitive transcranial magnetic stimulation concurrently ımproves mood and anxiety in patients using benzodiazepines. Neuromodulation 2020; 23(3): 380-383.
• Alonso P, Pujol J, Cardoner N, et al. Right prefrontal repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: a double-blind, placebo-controlled study. Am J Psychiatry 2001; 158(7): 1143-1145.
• Prasko J, Pasková B, Záleský R, et al. The effect of repetitive transcranial magnetic stimulation (rTMS) on symptoms in obsessive compulsive disorder. A randomized, double blind, sham controlled study. Neuro Endocrinol Lett 2006; 27(3): 327-332.
• Sachdev PS, Loo CK, Mitchell PB, et al. Repetitive transcranial magnetic stimulation for the treatment of obsessive compulsive disorder: a double-blind controlled investigation. Psychol Med 2007; 37(11): 1645-1649.
• Haghighi M, Shayganfard M, Jahangard L, et al. Repetitive transcranial magnetic stimulation (rTMS) improves symptoms and reduces clinical illness in patients suffering from OCD--results from a single-blind, randomized clinical trial with sham cross-over condition. J Psychiatr Res 2015; 68: 238-244.