2021年3月14日 星期日



中風後憂鬱的發生率在18%到33%之間。由於中風病人常合併失語,心理治療可能會受到限制。 重複性經顱磁刺激(rTMS)已被允許用於藥物反應差的憂鬱患者。 我們報告低頻rTMS(LF-rTMS)可改善中風後的憂鬱與失語。

Mr. C is a 72-year-old Chinese man with left ischemic stroke and aphasia who was brought to our psychiatric clinic due to depression, irritable mood, social withdrawal, and refused to rehabilitation. His symptoms started 1 year ago following second stroke. He had no history of bipolar disorder. His family history revealed no known bipolar disorder. His family did not want to use antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). They asked nonphamacological treatment. He scored 41 points on evaluation with 12 points on the Hamilton Depression Rating Scale (HAM-D), 45 points on Adaptive Behavior Assessment System-II (ABAS-II) and 0 points on the Young Mania Rating Scale (YMRS). Because his depression persisted and refuse rehabilitation, rTMS was used for his treatment, once daily for 10 sessions in 2 weeks. We used a Appolo TMS device, with a figure-eight coil, over the right prefrontal-cortex and motor cortex. We used 50% motor threshold, 1Hz frequency, 3000 each session.