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Modulação Neurofisiológica através da Estimulação Magnética Transcraniana Repetitiva: Perspetivas no Tratamento da Depressão Resistente
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Abstract(s)
A Depressão Major é uma condição incapacitante e cada vez mais prevalente, da qual
surge um subgrupo significativo de doentes que desenvolvem Depressão Resistente ao
Tratamento. Assim, surge a Estimulação Magnética Transcraniana Repetitiva, uma
intervenção promissora naquilo que é o tratamento da Depressão Resistente, oferecendo
uma abordagem não invasiva e com menor perfil de efeitos adversos associado, quando
comparado com terapias convencionais, como a Eletroconvulsivoterapia. A Estimulação
Magnética Transcraniana Repetitiva atua através da modulação da excitabilidade
cortical, influenciando circuitos neuronais associados à regulação do humor,
particularmente o Córtex Pré-Frontal Dorsolateral. O aumento da investigação e,
consequentemente, da evidência tem levado a avanços significativos no desenvolvimento
de novos protocolos de estimulação, assim como de abordagens cada vez mais
personalizadas, de forma a otimizar os resultados terapêuticos. Embora a eficácia da
Estimulação Magnética Repetitiva esteja bem documentada, alguns desafios persistem,
nomeadamente a variabilidade interindividual de resposta dos doentes e a necessidade
de estratégias de manutenção de eficácia a longo prazo. A presente revisão explora as
bases neurobiológicas, a evidência clínica atual e as perspetivas futuras desta terapia,
destacando o seu papel na gestão da Depressão Resistente.
Major Depressive Disorder is a debilitating and increasingly prevalent condition, from which a significant subgroup of patients develop Treatment-Resistant Depression. In this context, Repetitive Transcranial Magnetic Stimulation emerges as a promising intervention for the treatment of Resistant Depression, offering a non-invasive approach with a lower profile of associated adverse effects compared to conventional therapies, such as Electroconvulsive Therapy. Repetitive Transcranial Magnetic Stimulation acts by modulating cortical excitability, influencing neural circuits associated with mood regulation, particularly the Dorsolateral Prefrontal Cortex. Increased research and, consequently, growing evidence have led to significant advancements in the development of new stimulation protocols, as well as increasingly personalized approaches to optimize therapeutic outcomes. Although the efficacy of Repetitive Transcranial Magnetic Stimulation is well-documented, some challenges persist, namely the interindividual variability in patient response and the need for long-term efficacy maintenance strategies. This review explores the neurobiological foundations, current clinical evidence, and future perspectives of this therapy, highlighting its role in the management of Resistant Depression.
Major Depressive Disorder is a debilitating and increasingly prevalent condition, from which a significant subgroup of patients develop Treatment-Resistant Depression. In this context, Repetitive Transcranial Magnetic Stimulation emerges as a promising intervention for the treatment of Resistant Depression, offering a non-invasive approach with a lower profile of associated adverse effects compared to conventional therapies, such as Electroconvulsive Therapy. Repetitive Transcranial Magnetic Stimulation acts by modulating cortical excitability, influencing neural circuits associated with mood regulation, particularly the Dorsolateral Prefrontal Cortex. Increased research and, consequently, growing evidence have led to significant advancements in the development of new stimulation protocols, as well as increasingly personalized approaches to optimize therapeutic outcomes. Although the efficacy of Repetitive Transcranial Magnetic Stimulation is well-documented, some challenges persist, namely the interindividual variability in patient response and the need for long-term efficacy maintenance strategies. This review explores the neurobiological foundations, current clinical evidence, and future perspectives of this therapy, highlighting its role in the management of Resistant Depression.
Description
Keywords
Depressão Major Depressão Refratária Depressão Resistente Eletroconvulsivoterapia Estimulação Magnética Transcraniana
Repetitiva Neuromodulação Terapias Físicas