{"id":591,"date":"2024-10-10T11:30:53","date_gmt":"2024-10-10T02:30:53","guid":{"rendered":"https:\/\/wako-psy-clinic.com\/kimoto\/?p=591"},"modified":"2024-10-10T11:30:53","modified_gmt":"2024-10-10T02:30:53","slug":"tms%e6%b2%bb%e7%99%82%e3%81%ae%e7%b6%ad%e6%8c%81%e7%99%82%e6%b3%95%e3%81%ab%e3%81%a4%e3%81%84%e3%81%a6%e3%80%81%e5%8a%b9%e6%9e%9c%e3%81%af%e3%81%82%e3%82%8b%e3%81%8b%ef%bc%9f%e6%b2%bb%e7%99%82","status":"publish","type":"post","link":"https:\/\/wako-psy-clinic.com\/kimoto\/blog\/591.html","title":{"rendered":"TMS\u6cbb\u7642\u306e\u7dad\u6301\u7642\u6cd5\u306b\u3064\u3044\u3066\u3001\u52b9\u679c\u306f\u3042\u308b\u304b\uff1f\u6cbb\u7642\u983b\u5ea6\u306f\uff1f\u6839\u62e0\u3068\u306a\u308b\u8ad6\u6587\u306b\u3064\u3044\u3066"},"content":{"rendered":"\n
TMS\u6cbb\u7642\u306e\u7dad\u6301\u7642\u6cd5\u306b\u3064\u3044\u3066\u3001\u52b9\u679c\u306f\u3042\u308b\u304b\uff1f\u6cbb\u7642\u983b\u5ea6\u306f\uff1f\u6839\u62e0\u3068\u306a\u308b\u8ad6\u6587\u306b\u3064\u3044\u3066

\u4eca\u56de\u306f\u3001TMS\u6cbb\u7642\u306e\u7dad\u6301\u7642\u6cd5\u306b\u3064\u3044\u3066\u3001\u52b9\u679c\u306f\u3042\u308b\u304b\uff1f\u6cbb\u7642\u983b\u5ea6\u306f\uff1f\u6839\u62e0\u3068\u306a\u308b\u8ad6\u6587\u306b\u3064\u3044\u3066\u89e3\u8aac\u3057\u307e\u3059\u3002

TMS\u6cbb\u7642\u306e\u7dad\u6301\u7642\u6cd5\u306f\u3001\u4e3b\u306b\u3046\u3064\u75c5\u306a\u3069\u306e\u6162\u6027\u7684\u306a\u7cbe\u795e\u75be\u60a3\u306b\u5bfe\u3059\u308b\u9577\u671f\u7684\u306a\u52b9\u679c\u3092\u7dad\u6301\u3059\u308b\u76ee\u7684\u3067\u884c\u308f\u308c\u307e\u3059\u3002\u7dad\u6301\u7642\u6cd5\u306f\u3001\u521d\u56de\u306eTMS\u6cbb\u7642\u306b\u3088\u3063\u3066\u5f97\u3089\u308c\u305f\u52b9\u679c\u3092\u6301\u7d9a\u3055\u305b\u3001\u75c7\u72b6\u306e\u518d\u767a\u3084\u60aa\u5316\u3092\u9632\u3050\u305f\u3081\u306b\u91cd\u8981\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u4ee5\u4e0b\u306b\u3001TMS\u6cbb\u7642\u306e\u7dad\u6301\u7642\u6cd5\u306b\u95a2\u3059\u308b\u52b9\u679c\u3001\u6cbb\u7642\u983b\u5ea6\u3001\u6839\u62e0\u3068\u306a\u308b\u8ad6\u6587\u306b\u3064\u3044\u3066\u8aac\u660e\u3057\u307e\u3059\u3002

1. \u7dad\u6301\u7642\u6cd5\u306e\u52b9\u679c
\u2460\u52b9\u679c
TMS\u6cbb\u7642\u306e\u7dad\u6301\u7642\u6cd5\u306f\u3001\u7279\u306b\u3046\u3064\u75c5\u3084\u53cc\u6975\u6027\u969c\u5bb3\u306a\u3069\u306e\u7cbe\u795e\u75be\u60a3\u306b\u5bfe\u3057\u3066\u3001\u518d\u767a\u306e\u9632\u6b62\u3084\u75c7\u72b6\u306e\u60aa\u5316\u3092\u9632\u3050\u305f\u3081\u306b\u6709\u52b9\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u591a\u304f\u306e\u7814\u7a76\u3067\u306f\u3001\u521d\u671f\u306eTMS\u6cbb\u7642\u3067\u52b9\u679c\u304c\u5f97\u3089\u308c\u305f\u60a3\u8005\u306b\u5bfe\u3057\u3066\u3001\u7dad\u6301\u7642\u6cd5\u3092\u884c\u3046\u3053\u3068\u3067\u3001\u305d\u306e\u52b9\u679c\u304c\u6301\u7d9a\u3057\u3001\u75c7\u72b6\u306e\u518d\u767a\u7387\u304c\u4f4e\u4e0b\u3059\u308b\u3053\u3068\u304c\u5831\u544a\u3055\u308c\u3066\u3044\u307e\u3059\u3002

\u7279\u306b\u3001\u3046\u3064\u75c5\u306e\u60a3\u8005\u306b\u304a\u3044\u3066\u3001\u6025\u6027\u671f\u306eTMS\u6cbb\u7642\u306e\u5f8c\u306b\u5b9a\u671f\u7684\u306a\u7dad\u6301\u30bb\u30c3\u30b7\u30e7\u30f3\u3092\u53d7\u3051\u308b\u3053\u3068\u3067\u3001\u6539\u5584\u3055\u308c\u305f\u75c7\u72b6\u3092\u9577\u671f\u9593\u306b\u308f\u305f\u308a\u7dad\u6301\u3067\u304d\u308b\u3053\u3068\u304c\u78ba\u8a8d\u3055\u308c\u3066\u3044\u307e\u3059\u3002

\u6839\u62e0
2014\u5e74\u306b\u767a\u8868\u3055\u308c\u305f**Philip et al.\uff082014\uff09**\u306e\u7814\u7a76\u3067\u306f\u3001TMS\u6cbb\u7642\u3092\u53d7\u3051\u305f\u91cd\u5ea6\u3046\u3064\u75c5\u60a3\u8005\u306b\u5bfe\u3057\u3066\u3001\u7dad\u6301\u7642\u6cd5\u304c\u518d\u767a\u4e88\u9632\u306b\u6709\u52b9\u3067\u3042\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u307e\u3057\u305f\u3002\u3053\u306e\u7814\u7a76\u3067\u306f\u3001\u6025\u6027\u671f\u6cbb\u7642\u5f8c\u3001\u7dad\u6301\u7642\u6cd5\u3092\u53d7\u3051\u305f\u60a3\u8005\u306e\u5927\u591a\u6570\u304c1\u5e74\u9593\u306b\u308f\u305f\u3063\u3066\u75c7\u72b6\u306e\u518d\u767a\u3092\u9632\u3050\u3053\u3068\u304c\u3067\u304d\u305f\u3068\u5831\u544a\u3055\u308c\u3066\u3044\u307e\u3059\u3010\u53c2\u8003\u8ad6\u65871\u3011\u3002
Sackeim et al.\uff082020\uff09\u306e\u7814\u7a76\u3067\u3082\u3001\u9577\u671f\u7684\u306aTMS\u7dad\u6301\u7642\u6cd5\u304c\u3001\u7279\u306b\u85ac\u7269\u7642\u6cd5\u304c\u4e0d\u5341\u5206\u306a\u60a3\u8005\u306b\u5bfe\u3057\u3066\u3082\u52b9\u679c\u7684\u3067\u3042\u308a\u3001\u3046\u3064\u75c5\u306e\u518d\u767a\u7387\u3092\u5927\u5e45\u306b\u4f4e\u4e0b\u3055\u305b\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u307e\u3057\u305f\u3010\u53c2\u8003\u8ad6\u65872\u3011\u3002

2. \u6cbb\u7642\u983b\u5ea6
\u2460\u6025\u6027\u671f\u6cbb\u7642\u3068\u7dad\u6301\u7642\u6cd5\u306e\u9055\u3044
\u6025\u6027\u671f\u6cbb\u7642\uff1aTMS\u6cbb\u7642\u306f\u3001\u901a\u5e38\u3001\u6025\u6027\u671f\u6cbb\u7642\u3068\u3057\u3066\u9031\u306b5\u56de\u30014\u301c6\u9031\u9593\u306b\u308f\u305f\u3063\u3066\u884c\u308f\u308c\u307e\u3059\u3002\u3053\u306e\u671f\u9593\u306b\u304a\u3044\u3066\u3001\u60a3\u8005\u306f\u75c7\u72b6\u306e\u5927\u5e45\u306a\u6539\u5584\u3092\u7d4c\u9a13\u3057\u307e\u3059\u3002

\u7dad\u6301\u7642\u6cd5\uff1a\u6025\u6027\u671f\u6cbb\u7642\u306e\u5f8c\u3001TMS\u306e\u52b9\u679c\u3092\u9577\u671f\u9593\u306b\u308f\u305f\u3063\u3066\u7dad\u6301\u3059\u308b\u305f\u3081\u306b\u3001\u7dad\u6301\u7642\u6cd5\u304c\u884c\u308f\u308c\u307e\u3059\u3002\u7dad\u6301\u7642\u6cd5\u306e\u5177\u4f53\u7684\u306a\u983b\u5ea6\u306f\u60a3\u8005\u306e\u72b6\u614b\u306b\u5fdc\u3058\u3066\u7570\u306a\u308a\u307e\u3059\u304c\u3001\u901a\u5e38\u306f\u6708\u306b1\u56de\u304b\u3089\u6570\u56de\u7a0b\u5ea6\u3067\u3059\u3002

\u2461\u7dad\u6301\u7642\u6cd5\u306e\u6a19\u6e96\u7684\u306a\u983b\u5ea6
\u591a\u304f\u306e\u7814\u7a76\u3067\u306f\u3001\u7dad\u6301\u7642\u6cd5\u306f\u90311\u56de\u304b\u3089\u6708\u306b1\u301c2\u56de\u306e\u30da\u30fc\u30b9\u3067\u884c\u308f\u308c\u308b\u3053\u3068\u304c\u4e00\u822c\u7684\u3067\u3059\u3002\u521d\u56de\u306e\u6025\u6027\u671f\u6cbb\u7642\u3067\u75c7\u72b6\u304c\u5287\u7684\u306b\u6539\u5584\u3057\u305f\u5834\u5408\u3001\u6708\u306b1\u56de\u7a0b\u5ea6\u306e\u30bb\u30c3\u30b7\u30e7\u30f3\u3067\u52b9\u679c\u3092\u7dad\u6301\u3067\u304d\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059\u3002
\u72b6\u6cc1\u306b\u3088\u3063\u3066\u306f\u3001\u60a3\u8005\u306e\u72b6\u614b\u3092\u89b3\u5bdf\u3057\u306a\u304c\u3089\u3001\u30bb\u30c3\u30b7\u30e7\u30f3\u306e\u9593\u9694\u3092\u3055\u3089\u306b\u5e83\u3052\u308b\u3053\u3068\u3082\u53ef\u80fd\u3067\u3059\u3002\u7279\u306b\u3001\u9577\u671f\u9593\u5b89\u5b9a\u3057\u3066\u3044\u308b\u60a3\u8005\u306e\u5834\u5408\u3001\u7dad\u6301\u7642\u6cd5\u306e\u983b\u5ea6\u3092\u6e1b\u3089\u3057\u3066\u3044\u304f\u3053\u3068\u304c\u63a8\u5968\u3055\u308c\u307e\u3059\u3002

3. \u7dad\u6301\u7642\u6cd5\u306e\u6839\u62e0\u3068\u306a\u308b\u8ad6\u6587
\u8ad6\u65871\uff1aPhilip NS et al. (2014)
\u30bf\u30a4\u30c8\u30eb: \"Maintenance Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Depression: A Pilot Study\"
\u6982\u8981: \u3053\u306e\u7814\u7a76\u306f\u3001\u6cbb\u7642\u62b5\u6297\u6027\u3046\u3064\u75c5\u306e\u60a3\u8005\u3092\u5bfe\u8c61\u306b\u3001TMS\u306e\u7dad\u6301\u7642\u6cd5\u306e\u52b9\u679c\u3092\u8abf\u67fb\u3057\u307e\u3057\u305f\u3002\u6025\u6027\u671f\u306e\u6cbb\u7642\u306b\u7d9a\u3044\u3066\u7dad\u6301\u7642\u6cd5\u3092\u53d7\u3051\u305f\u60a3\u8005\u306f\u3001\u75c7\u72b6\u304c\u6539\u5584\u3057\u305f\u72b6\u614b\u3092\u7dad\u6301\u3057\u3001\u518d\u767a\u7387\u304c\u4f4e\u304b\u3063\u305f\u3068\u5831\u544a\u3055\u308c\u3066\u3044\u307e\u3059\u3002
\u7d50\u8ad6: \u7dad\u6301\u7642\u6cd5\u3092\u884c\u3046\u3053\u3068\u3067\u3001\u3046\u3064\u75c5\u306e\u75c7\u72b6\u304c\u9577\u671f\u306b\u308f\u305f\u3063\u3066\u6539\u5584\u3055\u308c\u3001\u518d\u767a\u304c\u9632\u6b62\u3055\u308c\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3053\u3068\u3092\u793a\u5506\u3057\u307e\u3057\u305f\u3002

\u8ad6\u65872\uff1aSackeim HA et al. (2020)
\u30bf\u30a4\u30c8\u30eb: \"Durability of Antidepressant Response to Repetitive Transcranial Magnetic Stimulation: Systematic Review and Meta-analysis\"
\u6982\u8981: TMS\u306e\u6297\u3046\u3064\u52b9\u679c\u304c\u3069\u306e\u7a0b\u5ea6\u6301\u7d9a\u3059\u308b\u304b\u3092\u8a55\u4fa1\u3059\u308b\u305f\u3081\u306b\u3001\u8907\u6570\u306e\u7814\u7a76\u3092\u30ec\u30d3\u30e5\u30fc\u3057\u3001\u30e1\u30bf\u5206\u6790\u3092\u884c\u3044\u307e\u3057\u305f\u3002\u6025\u6027\u671f\u6cbb\u7642\u5f8c\u306b\u7dad\u6301\u7642\u6cd5\u3092\u884c\u3046\u3068\u3001\u3046\u3064\u75c5\u306e\u518d\u767a\u7387\u304c\u6709\u610f\u306b\u4f4e\u4e0b\u3059\u308b\u3053\u3068\u304c\u78ba\u8a8d\u3055\u308c\u307e\u3057\u305f\u3002
\u7d50\u8ad6: TMS\u7dad\u6301\u7642\u6cd5\u306f\u3001\u7279\u306b\u85ac\u7269\u6cbb\u7642\u304c\u52b9\u679c\u7684\u3067\u306a\u3044\u60a3\u8005\u306b\u5bfe\u3057\u3066\u3001\u3046\u3064\u75c5\u518d\u767a\u306e\u4e88\u9632\u306b\u975e\u5e38\u306b\u6709\u52b9\u3067\u3042\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u3066\u3044\u307e\u3059\u3002

\u8ad6\u65873\uff1aJanicak PG et al. (2010)
\u30bf\u30a4\u30c8\u30eb: \"Durability of Clinical Benefit With Transcranial Magnetic Stimulation in the Treatment of Pharmacoresistant Major Depression: Assessment of Relapse During a 6-Month Controlled Follow-Up\"
\u6982\u8981: \u6cbb\u7642\u62b5\u6297\u6027\u3046\u3064\u75c5\u60a3\u8005\u306b\u5bfe\u3059\u308bTMS\u306e\u9577\u671f\u7684\u306a\u52b9\u679c\u3092\u8a55\u4fa1\u3057\u305f\u7814\u7a76\u3067\u3001\u6025\u6027\u671f\u6cbb\u7642\u5f8c\u306e6\u304b\u6708\u9593\u306e\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u3067\u3001\u7dad\u6301\u7642\u6cd5\u3092\u884c\u3046\u3053\u3068\u3067\u6cbb\u7642\u52b9\u679c\u304c\u6301\u7d9a\u3057\u305f\u3053\u3068\u304c\u78ba\u8a8d\u3055\u308c\u307e\u3057\u305f\u3002
\u7d50\u8ad6: \u6025\u6027\u671fTMS\u6cbb\u7642\u5f8c\u306b\u3001\u67081\u301c2\u56de\u306e\u7dad\u6301\u7642\u6cd5\u3092\u884c\u3046\u3053\u3068\u3067\u3001\u3046\u3064\u75c5\u306e\u75c7\u72b6\u304c\u6539\u5584\u3055\u308c\u305f\u72b6\u614b\u3092\u7dad\u6301\u3067\u304d\u308b\u3053\u3068\u304c\u308f\u304b\u308a\u307e\u3057\u305f\u3002

\u307e\u3068\u3081
TMS\u6cbb\u7642\u306e\u7dad\u6301\u7642\u6cd5\u306f\u3001\u6025\u6027\u671f\u6cbb\u7642\u306b\u3088\u3063\u3066\u5f97\u3089\u308c\u305f\u6539\u5584\u3092\u9577\u671f\u9593\u6301\u7d9a\u3055\u305b\u3001\u75c7\u72b6\u306e\u518d\u767a\u3092\u9632\u3050\u305f\u3081\u306b\u6709\u52b9\u3067\u3059\u3002\u7814\u7a76\u3067\u306f\u3001TMS\u7dad\u6301\u7642\u6cd5\u304c\u3046\u3064\u75c5\u3084\u6cbb\u7642\u62b5\u6297\u6027\u306e\u60a3\u8005\u306b\u5bfe\u3057\u3066\u3001\u7279\u306b\u518d\u767a\u4e88\u9632\u306b\u52b9\u679c\u7684\u3067\u3042\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u6cbb\u7642\u983b\u5ea6\u306f\u6708\u306b1\u301c2\u56de\u304c\u4e00\u822c\u7684\u3067\u3059\u304c\u3001\u60a3\u8005\u306e\u72b6\u614b\u306b\u5fdc\u3058\u3066\u8abf\u6574\u3055\u308c\u307e\u3059\u3002

\u7dad\u6301\u7642\u6cd5\u306e\u52b9\u679c\u306b\u3064\u3044\u3066\u306f\u3001Philip et al.\uff082014\uff09\u3084Sackeim et al.\uff082020\uff09\u306e\u7814\u7a76\u304c\u793a\u3059\u3088\u3046\u306b\u3001\u9577\u671f\u7684\u306a\u75c7\u72b6\u306e\u7ba1\u7406\u306b\u6709\u7528\u3067\u3042\u308b\u3068\u3044\u3046\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u3042\u308a\u307e\u3059\u3002

Is maintenance therapy for TMS treatment effective? What is the frequency of treatment? A child psychiatrist in Nagoya explains, citing relevant studies.

Hello, this is Dr. Koji Kato, child psychiatrist at Wako Clinic, Nagoya, operated by Eihoukai Medical Corporation.

In this article, I will explain the effectiveness, frequency, and supporting research for maintenance therapy in TMS (Transcranial Magnetic Stimulation) treatment.

TMS maintenance therapy is primarily conducted to maintain the long-term effects of the initial TMS treatment for chronic mental disorders such as depression. The purpose of maintenance therapy is to sustain the effects obtained through the initial TMS treatment and prevent symptom recurrence or worsening. Below, I will discuss the effectiveness of TMS maintenance therapy, treatment frequency, and supporting research.

1. Effectiveness of Maintenance Therapy
Effectiveness
Maintenance therapy for TMS is considered effective in preventing recurrence and mitigating worsening symptoms, particularly in patients with depression or bipolar disorder. Many studies report that patients who benefited from initial TMS treatment could maintain these benefits and experience a lower relapse rate through ongoing maintenance therapy.

In particular, for patients with depression, it has been confirmed that receiving regular maintenance sessions after the acute phase of TMS treatment can help sustain improvements over a long period.

Evidence In a study by Philip et al. (2014), TMS maintenance therapy was shown to be effective in preventing relapse in patients with severe depression. Most patients who received maintenance therapy after the acute treatment phase were able to prevent relapse for up to a year\u3010Reference Paper 1\u3011.

Sackeim et al. (2020) also demonstrated that long-term TMS maintenance therapy significantly reduced relapse rates in patients, especially those for whom medication therapy was insufficient\u3010Reference Paper 2\u3011.

2. Frequency of Treatment
Difference Between Acute Phase Treatment and Maintenance Therapy
Acute Phase Treatment: TMS is typically administered 5 times per week over a period of 4-6 weeks during the acute treatment phase, resulting in substantial symptom improvement.

Maintenance Therapy: After the acute phase, maintenance therapy is conducted to preserve the benefits of TMS over the long term. The specific frequency of maintenance therapy varies depending on the patient's condition, but it is generally administered once to a few times per month.

Standard Frequency of Maintenance Therapy
Most studies suggest that maintenance therapy is performed once a week to 1-2 times a month. For patients who experience significant improvement during the initial phase, a monthly session may be sufficient to maintain the effects. In some cases, the frequency of sessions can be further reduced, particularly for patients who have been stable over an extended period.

3. Supporting Research on Maintenance Therapy
Study 1: Philip NS et al. (2014)
Title: \"Maintenance Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Depression: A Pilot Study\"
Summary: This study investigated the efficacy of TMS maintenance therapy in patients with treatment-resistant depression. The study found that patients who received maintenance therapy following the acute phase were able to sustain symptom improvements and had a lower relapse rate.
Conclusion: Maintenance therapy can help ensure long-term improvement in depressive symptoms and prevent relapse.

Study 2: Sackeim HA et al. (2020)
Title: \"Durability of Antidepressant Response to Repetitive Transcranial Magnetic Stimulation: Systematic Review and Meta-analysis\"
Summary: This study reviewed and conducted a meta-analysis of multiple studies to evaluate how long the antidepressant effects of TMS last. It confirmed that maintenance therapy following the acute phase significantly reduced the relapse rate for depression.
Conclusion: TMS maintenance therapy is highly effective in preventing relapse, especially in patients for whom medication therapy has been ineffective.

Study 3: Janicak PG et al. (2010)
Title: \"Durability of Clinical Benefit With Transcranial Magnetic Stimulation in the Treatment of Pharmacoresistant Major Depression: Assessment of Relapse During a 6-Month Controlled Follow-Up\"
Summary: This study evaluated the long-term efficacy of TMS in patients with treatment-resistant depression. It found that maintenance therapy following acute-phase treatment helped sustain the benefits for 6 months.
Conclusion: Monthly maintenance therapy (1-2 times) following acute TMS treatment can help maintain the improvement in depressive symptoms.

Conclusion
TMS maintenance therapy is effective in sustaining the improvements gained from the initial treatment and preventing symptom recurrence. Studies indicate that TMS maintenance therapy is particularly effective in preventing relapse in patients with depression and treatment-resistant conditions. The standard treatment frequency is typically 1-2 times per month, though this can be adjusted based on the patient's condition.

The effectiveness of maintenance therapy is well-supported by research, including studies by Philip et al. (2014) and Sackeim et al. (2020), which provide evidence for the long-term management of symptoms.
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