Rov Los Ua Cov Hloov Transcranial Sib Nqus

Zoo Siab

• Vim li cas rTMS siv?
• RTMS ua haujlwm li cas?
• Cov kev mob tshwm sim thiab kev pheej hmoo ntawm rTMS yog dab tsi?
• RTMS muab piv rau ECT li cas?
• Leej twg yuav tsum zam rTMS?
• Tus nqi ntawm rTMS yog dab tsi?
• Lub sij hawm ntawm rTMS yog dab tsi?
• Cov kws txawj hais dab tsi txog rTMS?

Thaum siv tshuaj los kho kev nyuaj siab tsis ua hauj lwm, cov kws kho mob yuav sau ntawv rau lwm txoj kev kho mob, xws li rov kho transcranial sib nqus (rTMS).

Txoj kev kho no suav nrog siv hlau nplaum sib nqus los tua rau qee qhov ntawm lub hlwb. Tib neeg tau siv nws txij li xyoo 1985 los daws qhov kev mob siab thiab kev xav tsis muaj kev cia siab uas tuaj yeem nrog kev nyuaj siab.

Yog tias koj lossis tus neeg hlub tau sim ntau txoj hauv kev rau kev kho kev mob siab yam tsis muaj kev vam meej, rTMS yuav yog qhov kev xaiv.

Vim li cas rTMS siv?

FDA tau pom zoo rTMS los kho kev mob hnyav thaum lwm yam kev kho mob (xws li tshuaj kho mob thiab kho mob hlwb) tsis tau ua tiav txaus.

Qee zaum, cov kws kho mob tuaj yeem ua ke rTMS nrog cov kev kho mob ib txwm muaj, suav nrog cov tshuaj tiv thaiv kev ntxhov siab.

Koj yuav tau txais txiaj ntsig ntau tshaj plaws los ntawm rTMS yog tias koj muaj raws li cov hauv qab no:

• Koj tau sim lwm txoj kev kho kev nyuaj siab, xws li tsawg kawg ib zaug tshuaj tiv thaiv kab mob, tsis muaj kev vam meej.
• Koj tsis muaj kev noj qab haus huv zoo txaus rau cov txheej txheem xws li kev kho mob electroconvulsive (ECT). Qhov no muaj tseeb yog tias koj muaj keeb kwm mob qaug dab peg lossis tsis tuaj yeem zam lub tshuaj loog zoo rau tus txheej txheem.
• Tam sim no koj tsis tau siv tshuaj yeeb los yog dej caw.

Yog tias cov suab zoo li koj no, koj yuav tsum nrog koj tus kws kho mob tham txog rTMS. Nws yog ib qho tseem ceeb kom nco ntsoov tias rTMS tsis yog thawj txoj kev kho mob, yog li koj yuav tau sim ua lwm yam ua ntej.

RTMS ua haujlwm li cas?

Qhov no yog qhov txheej txheem tsis yog qhov sib txawv uas feem ntau yuav siv sijhawm 30 thiab 60 feeb los ua.

Nov yog yam uas koj tuaj yeem xav tau ntawm kev kho mob rTMS:

• Koj yuav tsum zaum lossis zaum rov qab thaum kws kho mob tso lub tshuab hluav taws xob tshwj xeeb nyob ze koj lub taub hau, tshwj xeeb rau thaj tsam ntawm lub hlwb uas tswj txoj kev xav.
• Lub kauj ntab tsim cov hlau nplaum sib nqus rau koj lub hlwb. Qhov hnov ​​tsis zoo li tsis mob, tab sis nws yuav hnov ​​zoo li chia los sis npuaj taub hau.
• Cov kab hluav taws xob no tsim hluav taws xob hauv koj cov hlab ntsha.
• Koj tuaj yeem rov pib koj cov haujlwm txhua hnub (suav nrog kev tsav tsheb) tom qab rTMS.

Nws tau xav tias cov hluav taws xob hluav taws xob tam sim no txhawb cov hlwb hlwb ua ib txoj hauv kev yooj yim uas tuaj yeem txo kev ntxhov siab. Qee tus kws kho mob tso tus coil tso rau ntau qhov chaw hauv lub hlwb.

Cov kev mob tshwm sim thiab kev pheej hmoo ntawm rTMS yog dab tsi?

Qhov mob tsis feem ntau yog phiv los ntawm rTMS, tab sis qee tus neeg qhia tias tsis xis nyob nrog tus txheej txheem. Lub tshuab hluav taws xob xaiv tuaj yeem ua rau cov leeg nqaij ntawm lub ntsej muag zawm lossis khi.

Cov txheej txheem cuam tshuam nrog cov kev mob tshwm sim me rau mob pes tsawg, suav nrog:

• kev xav ntawm lightheadedness
• lub rooj sib hais ib ntus vim hais tias qee zaum nrov nrov suab nrov
• mob taub hau me me
• tingling hauv lub ntsej muag, puab tsaig, lossis tawv taub hau

Txawm tias tsawg, rTMS tuaj nrog kev pheej hmoo me me ntawm qaug dab peg.

RTMS muab piv rau ECT li cas?

Cov kws kho mob tuaj yeem muab cov tshuaj kho mob hlwb ntau zaug uas tuaj yeem pab kho kev nyuaj siab. Thaum rTMS yog ib qho, lwm qhov yog kev kho mob electroconvulsive (ECT).

ECT koom nrog tso cov electrodes rau cov chaw muaj tswv yim ntawm lub hlwb thiab lub tshuab hluav taws xob uas tseem ceeb ua rau qaug dab peg tshwm sim hauv lub hlwb.

Cov kws kho mob ua cov txheej txheem nyob rau hauv kev siv tshuaj loog, uas txhais tau tias koj tsaug zog thiab tsis paub txog koj ib puag ncig.Cov kws kho mob tseem muab koj cov leeg ua kom zoo, uas ua kom koj tsis txhob tshee tshee thaum txoj kev kho ntawm kev kho mob.

Qhov no txawv ntawm rTMS vim tias cov neeg tau txais rTMS tsis tas yuav tsum tau txais tshuaj loog, uas tuaj yeem txo qhov txaus ntshai rau cov kev mob tshwm sim.

Ib qho ntawm lwm qhov sib txawv ntawm ob qho no yog rab peev xwm los tua qee yam ntawm lub hlwb.

Thaum rTMS kauj tau tuav hla qee qhov chaw ntawm lub hlwb, lub impulses taug kev tsuas yog mus rau ntu ntawd lub hlwb. ECT tsis yog phiaj xwm tshwj xeeb.

Thaum cov kws kho mob siv ob qho RTMS thiab ECT los kho kev nyuaj siab, ECT ib txwm yog kho rau kev kho mob hnyav thiab muaj feem yuav txo tau txoj sia.

Lwm yam mob thiab cov tsos mob kws kho mob yuav siv ECT los kho xws li:

• kev puas siab puas ntsws bipolar
• mob schizophrenia
• yus tua yus xav
• catatonia

Leej twg yuav tsum zam rTMS?

Thaum rTMS tsis muaj cov kev mob tshwm sim ntau, nws tseem muaj qee tus neeg uas tsis xav tau nws. Koj tsis yog ib tus neeg sib tw yog tias koj muaj hlau cuam cog lossis npaws ib qhov twg hauv koj lub taub hau lossis caj dab.

Piv txwv ntawm cov neeg uas tsis tau txais rTMS suav nrog cov uas nrog:

• aneurysm clips lossis coils
• mos txwv tawg lossis cov mos txwv nyob ze lub taub hau
• mob raum lossis txoj hlab ntshav ua kom tsis taus (ICD)
• Cov ntsej muag pleev ntsej muag uas muaj mem hluav sib nqus lossis mem kua uas rhiab tau hlau nplaum
• cog lus stimulators
• hlau cuam tshuam hauv pob ntseg lossis qhov muag
• stents hauv caj dab lossis lub hlwb

Tus kws kho mob yuav tsum ua qhov kev kuaj mob kom zoo thiab siv keeb kwm kev kho mob ua ntej siv txoj kev kho. Nws tseem ceeb heev uas yuav tau qhia tawm ib qho ntawm cov kev pheej hmoo pheej hmoo no kom koj nyab xeeb.

Tus nqi ntawm rTMS yog dab tsi?

Txawm hais tias rTMS tau nyob ntev dua 30 xyoo los, nws tseem yog qhov tshiab rau lub chaw kho kev nyuaj siab. Raws li qhov tshwm sim, tsis muaj lub cev loj ntawm kev tshawb fawb raws li qee qhov kev kho mob nyuaj siab. Qhov no txhais tau tias cov tuam txhab tuav pov hwm yuav tsis them rau cov kev kho mob rTMS.

Feem ntau cov kws kho mob yuav kom koj hu rau koj lub tuam txhab kev pov hwm kom paub seb lawv puas kam kho mob rTMS. Cov lus teb yuav nyob ntawm koj li kev noj qab haus huv thiab kev tuav pov hwm. Qee zaum, koj lub tuam txhab kev pov hwm yuav tsis them tag nrho cov nqi, tab sis tsawg kawg them ib feem.

Thaum cov nqi kho mob tuaj yeem sib txawv raws qhov chaw nyob, cov nqi nruab nrab yuav yog los ntawm kev kho ib zaug.

Medicare feem ntau them rov cov nyiaj mob rTMS ntawm qhov nruab nrab. Ib tus neeg yuav muaj nyob qhov twg li ntawm 20 txog 30 lossis ntau zaus kev kho mob tauj ib xyoos.

Lwm qhov kev tshawb fawb qhia tias tus neeg yuav them li ntawm $ 6,000 txog $ 12,000 txhua xyoo rau kev kho mob rTMS. Thaum cov nqe no pom zoo li lub siab thaum xav xyoo ib lub sijhawm, txoj kev kho yuav raug nqi zoo dua thaum piv nrog kev siv lwm yam kev kho kev nyuaj siab uas tsis ua haujlwm zoo.

Qee lub tsev kho mob, chaw kho mob cov chaw haujlwm, thiab cov chaw kho mob muaj cov phiaj xwm them nqi lossis txo tus nqi them rau cov neeg tsis tuaj yeem them tus nqi.

Lub sij hawm ntawm rTMS yog dab tsi?

Cov kws kho mob yuav tsim ib qho tshuaj rau ib tus neeg thaum nws tuaj kho mob. Txawm li cas los xij, neeg feem coob yuav mus rau kev kho mob uas yuav kav ntev li 30 mus rau 60 feeb txog 5 zaug hauv ib lub lis piam.

Lub sijhawm kho mob feem ntau kav 4 rau 6 lub lis piam. Tus lej ntawm lub lis piam no tuaj yeem ua luv lossis ntev dua nyob ntawm cov tib neeg cov lus teb.

Cov kws txawj hais dab tsi txog rTMS?

Ib tug xov tooj ntawm cov kev tshawb fawb soj ntsuam thiab cov chaw kuaj mob tau sau rau hauv rTMS. Qee qhov ntawm cov txiaj ntsig tau muaj xws li:

• Kev tshawb fawb 2018 pom tias cov neeg uas tau teb rau rTMS los ntawm kev nce lawv cov theta thiab alpha lub hlwb kev ua si tau zoo dua yuav ua rau lawv txoj kev xav zoo. Qhov kev tshawb nrhiav tib neeg me me no yuav pab kwv yees tau leej twg yuav teb rau rTMS.
• Ib qho pom tias kev kho mob yog qhov tsim nyog rau cov neeg uas muaj kev nyuaj siab kho tsis tau noj tshuaj thiab leej twg muaj kev ntxhov siab tseem ceeb.
• Ib qho pom ntawm rTMS nrog rau ECT tuaj yeem txo qhov tsawg ntawm qhov yuav tsum tau ECT thiab cia tus neeg tau txais kev kho mob nrog rTMS tom qab kev pib ECT kev kho mob. Cov kev sib txuas ua ke no tuaj yeem pab txo qis cov kev tsis zoo ntawm ECT.
• Xyoo 2019 cov ntaub ntawv tshuaj xyuas pom rTMS muaj txiaj ntsig zoo rau kev kho mob tom qab ib qho kev sim tshuaj tau ua haujlwm zoo hauv kev kho mob tsis txaus siab loj.

Ntau cov kev tshawb fawb tam sim no nyob rau hauv kev kawm muaj cov kws tshawb nrhiav tshuaj xyuas qhov cuam tshuam mus sij hawm ntev ntawm rTMS thiab nrhiav seb hom mob twg zoo tshaj plaws rau kev kho mob.