重复经颅磁刺激治疗青少年抑郁症非自杀性自伤行为的研究进展  

Research progress of repetitive transcranial magnetic stimulation in the treatment of non-suicidal self-injury behavior in adolescents with depression

作　　者：杨侃 申璎 方锋峰 唐宏 YANG Kan;SHEN Ying;FANG Feng-feng;TANG Hong(The First Clinical Medical School of Gannan Medical University;Department of Psychosomatic Medicine,The Third People's Hospital of Ganzhou;School of Humanities and Social Sciences,Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医科大学第一临床医学院 [2]赣州市第三人民医院心身医学科 [3]赣南医科大学人文社会科学学院,江西赣州341000

出　　处：《赣南医科大学学报》2025年第2期177-182,共6页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：江西省哲学社会科学重点研究基地项目(23ZXSKJD51)。

摘　　要：非自杀性自伤(Non-suicidal self-injury,NSSI)是指在无自杀意图的情况下故意伤害自己身体的行为,是青少年常见的心理健康问题。近年来,在青少年抑郁症患者中,NSSI的发生率呈现上升趋势。重复经颅磁刺激(Repetitive transcranial magnetic stimulation,rTMS)作为一种非侵入性的神经调节技术,已被用于改善抑郁症和焦虑症患者的情绪问题,并且越来越多的研究表明,rTMS也能改善青少年抑郁症患者的NSSI行为,且安全性高、不良反应少。本文综合近年来国内外文献,从青少年NSSI的发病机制、青少年抑郁症与NSSI的关系以及rTMS治疗青少年抑郁症NSSI行为等方面进行综述。文献复习结果表明,rTMS联合抗抑郁药物治疗能显著提高伴有NSSI行为的青少年抑郁症患者的治疗效果,不仅增强了抗抑郁作用,还有效减少了自伤行为的频率和严重程度。然而,目前对于rTMS的最佳刺激模式和参数尚未达成共识,且rTMS治疗青少年抑郁症NSSI行为的具体作用机制有待进一步阐明。将来的研究可利用磁共振成像(Magnetic resonance imaging,MRI)和近红外光谱成像(Near-infrared spectroscopic imaging,NIRS)等先进的成像技术来精确定位治疗靶点,从而使rTMS治疗更加个性化,为患者提供更精准、更有效的治疗方案。Non-suicidal self-injury(NSSI),which is the act of intentionally harming one's own body without suicidal intent,is a common mental health problem among adolescents.In recent years,the incidence of NSSI has shown an increasing trend among adolescents with depression.Repetitive transcranial magnetic stimulation(rTMS),as a non-invasive neuromodulation technique,has been used to improve mood problems in patients with depression and anxiety disorders.More and more studies have shown that rTMS also improves NSSI behaviors in adolescents with depression with a high degree of safety and few side effects.This paper will synthesize the research literature from home and abroad in recent years,and review three aspects of the pathogenesis of adolescent NSSI,the relationship between adolescent depression and NSSI,and the treatment of adolescent depression NSSI behavior with rTMS.The results of the literature review show that rTMS combined with antidepressant medication can significantly improve the therapeutic efficacy of adolescent depression patients with NSSI behaviors,which not only enhances the antidepressant effect,but also effectively reduces the frequency and severity of self-injury.However,there is no consensus on the optimal stimulation modes and parameters for rTMS,and the specific mechanism of action of rTMS for the treatment of NSSI behaviors in adolescent depression remains to be further elucidated.Future studies could utilize advanced imaging techniques such as magnetic resonance imaging(MRI)and near-infrared spectroscopic imaging(NIRS)to pinpoint therapeutic targets,thus making rTMS treatment more personalized and providing patients with more precise and effective treatment.

关 键 词：青少年抑郁症 非自杀性自伤 重复经颅磁刺激 

分 类 号：R749.059[医药卫生—神经病学与精神病学]