Journal of the Korean society of biological therapies in psychiatry (생물치료정신의학)

The Korean Society of Biological Therapies in Psychiatry (대한생물치료정신의학회)
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The Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Treatment-Resistant Tourette's Syndrome among Children and Adolescents : An Open-Label Study

치료저항성 뚜렛장애를 가진 소아청소년에서 저빈도 반복적 경두개자기자극술의 효과 : 오픈 라벨 연구

  • Lee, Young-Ji (Department of Psychiatry, Yeungnam University College of Medicine) ;
  • Chae, Jin Hyuk (Department of Psychiatry, Yeungnam University College of Medicine) ;
  • Seo, Wan Seok (Department of Psychiatry, Yeungnam University College of Medicine)
  • 이영지 (영남대학교 의과대학 정신건강의학교실) ;
  • 채진혁 (영남대학교 의과대학 정신건강의학교실) ;
  • 서완석 (영남대학교 의과대학 정신건강의학교실)
  • Received : 2018.10.08
  • Accepted : 2018.10.10
  • Published : 2018.10.31

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Abstract

목 적 : 본 연구의 목적은 치료저항성 뚜렛장애를 가진 소아 청소년들에 대해서 보조운동영역을 표적으로 한 저빈도 반복적 경두개자기자극술의 효과를 평가하는 것이다. 방 법 : 이 연구는 미국정신의학회 진단기준 및 통계편람, 제 4판을 기준으로 뚜렛장애로 진단받은 10명의 소아 청소년(평균연령 $12.56{\pm}1.04$세)을 대상으로 하였다. 모든 참가자들은 1년 이상 지속적으로 충분한 용량의 약물치료를 받았음에도 불구하고 한국판 예일 틱 증상 평가척도(YGTSS) 20점 이상, 임상인상척도(CGI-TS) 4점 이상을 받았다. 참가자들은 보조운동영역을 표적으로 1 Hz 반복적 경두개자기자극 치료를 매일 20분간 받았으며, 총 20회 치료를 받았다. YGTSS, CGI-TS 및 이상반응 체크리스트는 연구 시작 전과 연구 시작 후 4, 8, 12주에 시행되었다. 결 과 : 틱 증상은 연구 12주차까지 호전된 상태로 지속되었으며, YGTSS와 CGI-TS가 통계적으로 유의하게 감소하였다. 특히 음성 틱 점수의 감소가 운동 틱 점수의 변화보다 전체 YGTSS 점수의 감소에 큰 역할을 한 것으로 나타났다. 그리고 전체 10명의 참가자 중 9명이 심각한 부작용 없이 연구를 끝까지 완료하였다. 결 론 : 본 연구는 보조운동영역을 표적으로 한 저빈도 반복적 경두개자기자극술이 치료 저항성 뚜렛장애를 가진 소아 청소년들에게 효과적이고 안전한 치료도구가 될 수 있음을 시사한다. 이러한 반복적 경두개자기자극술의 치료효과를 확정하기 위해서는 보다 많은 환자를 대상으로 한 잘 통제된 연구가 필요할 것이다.

Keywords

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