뇌 자극술을 이용한 노년기 우울증의 치료
Treatment of Late-Life Depression by Brain Stimulation Techniques
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초록
Due to the low response rate of antidepressant treatment in late-life depression, brain stimulation techniques should be consid- ered when treating elderly patients. Electroconvulsive therapy (ECT) is one of the most frequently used brain stimulation techniques, and shows favorable outcome and acceptable tolerability in the treatment of late-life depression. Cardiovascular change and cog- nitive impairment are common side effects of ECT, which are transient in most cases. Since cognitive impairment can lead to treat- ment non-compliance, it should be minimized by controlling electrode position, pulse-width, treatment frequency, etc. Because ECT is followed by rapid cardiovascular change, risk factors should be evaluated and managed properly. Transcranial magnetic stimulation (TMS) and magnetic seizure therapy (MST) are also effective in treating depression, and known to have less cognitive impairment. However, further research is needed to establish their efficacy in late-life depression.
Abstract
Due to the low response rate of antidepressant treatment in late-life depression, brain stimulation techniques should be consid- ered when treating elderly patients. Electroconvulsive therapy (ECT) is one of the most frequently used brain stimulation techniques, and shows favorable outcome and acceptable tolerability in the treatment of late-life depression. Cardiovascular change and cog- nitive impairment are common side effects of ECT, which are transient in most cases. Since cognitive impairment can lead to treat- ment non-compliance, it should be minimized by controlling electrode position, pulse-width, treatment frequency, etc. Because ECT is followed by rapid cardiovascular change, risk factors should be evaluated and managed properly. Transcranial magnetic stimulation (TMS) and magnetic seizure therapy (MST) are also effective in treating depression, and known to have less cognitive impairment. However, further research is needed to establish their efficacy in late-life depression.
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