Kulimbikitsana Kwa Magnetic Transcranial Magnetic

Zamkati

• Chifukwa chiyani ma rTMS amagwiritsidwa ntchito?
• Kodi rTMS imagwira ntchito bwanji?
• Zotsatira zoyipa ndi zovuta za rTMS ndi ziti?
• Kodi ma rTMS amafanizira bwanji ndi ECT?
• Ndani ayenera kupewa rTMS?
• Kodi mitengo ya rTMS ndi yotani?
• Kodi ma rTMS ndiotani?
• Kodi akatswiri amati chiyani za rTMS?

Ngati njira zochiritsira zochizira kukhumudwa sizikugwira ntchito, madotolo amatha kupereka njira zina zamankhwala, monga kubwereza maginito opitilira muyeso (rTMS).

Chithandizochi chimaphatikizapo kugwiritsa ntchito maginito poyang'ana mbali zina za ubongo. Anthu akhala akugwiritsa ntchito kuyambira 1985 kuti athetse chisoni chachikulu ndikudzimva kukhala opanda chiyembekezo komwe kumabwera ndi kukhumudwa.

Ngati inu kapena wokondedwa mwayesa njira zingapo zochiritsira kukhumudwa osapambana, rTMS itha kukhala njira.

Chifukwa chiyani ma rTMS amagwiritsidwa ntchito?

FDA idavomereza ma rTMS kuti athetse kukhumudwa kwakukulu pomwe mankhwala ena (monga mankhwala ndi psychotherapy) sanakwaniritse bwino.

Nthawi zina, madotolo amatha kuphatikiza ma rTMS ndi mankhwala achikhalidwe, kuphatikiza mankhwala opatsirana.

Mutha kupindula kwambiri ndi rTMS mukakwaniritsa izi:

• Mwayesapo njira zina zochiritsira kukhumudwa, monga imodzi yokha, koma osapambana.
• Simuli ndi thanzi labwino mokwanira ngati njira zamagetsi zamagetsi (ECT). Izi ndizowona ngati mwakhala mukugwidwa kale kapena simutha kupirira mankhwala ochititsa dzanzi kuti muchite izi.
• Simukuvutika pakadali pano ndi zovuta zakumwa kapena mowa.

Ngati izi zikumveka ngati inu, mungafune kulankhula ndi dokotala za rTMS. Ndikofunika kuzindikira kuti rTMS si mankhwala oyamba, chifukwa chake muyenera kuyesa zinthu zina poyamba.

Kodi rTMS imagwira ntchito bwanji?

Imeneyi ndi njira yosawerengeka yomwe nthawi zambiri imatenga pakati pa 30 ndi 60 mphindi kuti ichitike.

Izi ndi zomwe mungayembekezere pachikhalidwe cha rTMS:

• Mukhala kapena kutsamira pomwe dokotala amaika koyilo yapadera yamagetsi pafupi ndi mutu wanu, makamaka gawo laubongo lomwe limayendetsa kusinthasintha kwa malingaliro.
• Chophimbacho chimapangitsa kuti maginito azitulutsa ubongo wanu. Kutengeka sikumapweteka, koma kumatha kumva ngati kugogoda kapena kugogoda pamutu.
• Mitengoyi imatulutsa mafunde amagetsi m'mitsempha yanu.
• Mutha kuyambiranso zochitika zanu zonse (kuphatikiza kuyendetsa) pambuyo pa rTMS.

Amaganiziridwa kuti mafunde amagetsi amenewa amalimbikitsa ma cell amubongo m'njira yovuta yomwe ingachepetse kukhumudwa. Madokotala ena amatha kuyika kolayo m'malo osiyanasiyana amubongo.

Zotsatira zoyipa ndi zovuta za rTMS ndi ziti?

Zowawa sizimakhala zoyipa za rTMS, koma anthu ena amafotokoza kusapeza bwino ndi njirayi. Mitundu yamagetsi yamagetsi imatha kupangitsa kuti nkhope kumangika kapena kumenyera.

Njirayi imalumikizidwa ndi zovuta zoyipa pang'ono, kuphatikiza:

• kumverera kwa mutu wopepuka
• mavuto akumva kwakanthawi chifukwa cha phokoso lamphamvu la maginito nthawi zina
• mutu wofatsa
• kumva kulira kumaso, nsagwada, kapena pamutu

Ngakhale ndizosowa, ma rTMS amabwera ndi chiopsezo chochepa chogwidwa.

Kodi ma rTMS amafanizira bwanji ndi ECT?

Madokotala amatha kupereka njira zingapo zolimbikitsira ubongo zomwe zingathandize kuthana ndi kukhumudwa. Ngakhale rTMS ndi imodzi, ina ndi ma electroconvulsive therapy (ECT).

ECT imaphatikizapo kuyika ma elekitirodi m'malo abwino amubongo ndikupanga magetsi omwe amachititsa kuti kugwidwa kuchitika muubongo.

Madokotala amachita njirayi pansi pa anesthesia wamba, zomwe zikutanthauza kuti mukugona ndipo simudziwa komwe mukukhala.Madokotala amakupatsaninso minofu yopumulira, yomwe imakutetezani kuti musagwedezeke panthawi yolimbikitsayi ya chithandizo.

Izi zimasiyana ndi rTMS chifukwa anthu omwe amalandira ma rTMS sayenera kulandira mankhwala a sedation, omwe amachepetsa zovuta zomwe zingachitike.

Chimodzi mwazosiyana zazikulu pakati pa ziwirizi ndi kuthekera kolunjika kumadera ena aubongo.

Ma coil a rTMS akagwira gawo lina laubongo, zikhumbo zimangopita kudera limenelo laubongo. ECT siikulimbana ndi madera enaake.

Ngakhale madotolo amagwiritsa ntchito ma rTMS ndi ECT kuthana ndi kukhumudwa, ECT nthawi zambiri imasungidwa kuti ithetse kukhumudwa koopsa komanso koopsa.

Zina ndi zizindikiritso zomwe madokotala amatha kugwiritsa ntchito ECT kuchiza ndi monga:

• matenda ochititsa munthu kusinthasintha zochitika
• schizophrenia
• Maganizo ofuna kudzipha
• katatonia

Ndani ayenera kupewa rTMS?

Ngakhale rTMS ilibe zovuta zambiri, pali anthu ena omwe sayenera kuzipeza. Simukuyimira ngati muli ndi chitsulo kapena chophatikizika penapake pamutu kapena m'khosi.

Zitsanzo za anthu omwe sayenera kulandira ma rTMS ndi omwe ali ndi:

• matupi a aneurysm kapena ma coil
• Zidutswa zazipolopolo kapena zotchingira pafupi ndi mutu
• opanga masewera a mtima kapena opangira zida zama mtima (ICD)
• ma tatoo akumaso omwe ali ndi inki yamaginito kapena inki yomwe imazindikira maginito
• opatsa mphamvu
• zopangira chitsulo m'makutu kapena m'maso
• zowawa m'khosi kapena muubongo

Dokotala amayenera kuwunikiridwa bwino ndikulemba mbiri ya zamankhwala asanagwiritse ntchito mankhwalawa. Ndikofunika kwambiri kuwulula chilichonse mwazomwe zitha kukhala pachiwopsezo kuti mukhale otetezeka.

Kodi mitengo ya rTMS ndi yotani?

Ngakhale rTMS yakhala ikuchitika kwazaka zopitilira 30, ikadali yatsopano kwachipatala. Zotsatira zake, palibe gulu lalikulu lofufuzira monga mankhwala ena opsinjika. Izi zikutanthauza kuti makampani a inshuwaransi sangaphimbe chithandizo cha rTMS.

Madokotala ambiri amalangiza kuti muthane ndi kampani yanu ya inshuwaransi kuti mudziwe ngati akupereka chithandizo cha rTMS. Yankho lake limadalira thanzi lanu komanso inshuwaransi yanu. Nthawi zina, kampani yanu ya inshuwaransi mwina siyimalipira zonse, koma amalipira gawo.

Ngakhale ndalama zochiritsira zimatha kusiyanasiyana kutengera komwe kuli, ndalama zomwe zimafunikira zitha kukhala zosiyanasiyana kuchipatala.

Medicare nthawi zambiri imabwezera ma rTMS pafupifupi. Munthu amatha kulandira chithandizo kuyambira 20 mpaka 30 kapena kupitilira apo pachaka.

Kafukufuku wina akuwonetsa kuti munthu amatha kulipira pakati pa $ 6,000 ndi $ 12,000 pachaka kuchipatala cha rTMS. Ngakhale mtengo wake ungaoneke wokwera poganizira chaka chimodzi, mankhwalawa akhoza kukhala othandiza poyerekeza ndi kugwiritsa ntchito mankhwala ena opsinjika maganizo omwe sagwira bwino ntchito.

Zipatala zina, maofesi a madokotala, ndi zipatala zimapereka mapulani olipira kapena kuchotsera mapulogalamu kwa iwo omwe sangathe kulipira ndalama zonse.

Kodi ma rTMS ndiotani?

Madokotala amapanga mankhwala kwa munthu zikafika pachithandizo. Komabe, anthu ambiri amapita kuchipatala komwe amakhala pafupifupi mphindi 30 mpaka 60 pafupifupi kasanu pamlungu.

Kutalika kwa chithandizo nthawi zambiri kumakhala pakati pa masabata 4 mpaka 6. Nambala iyi yamasabata imatha kukhala yayifupi kapena yayitali kutengera kuyankha kwa munthu.

Kodi akatswiri amati chiyani za rTMS?

Mayeso angapo ofufuza ndi kuwunika kwamankhwala kwalembedwa pa rTMS. Zotsatira zake ndi izi:

• Kafukufuku wa 2018 adapeza kuti anthu omwe adayankha ma rTMS powonjezera zochitika zawo za theta ndi alpha brainwave amatha kusintha malingaliro awo. Phunziro laling'ono laumunthu ili lingathandize kuneneratu yemwe angayankhe kwambiri ku rTMS.
• Chomwe chapezeka ndichoti ndi choyenera kwa iwo omwe kukhumudwa kwawo kulimbana ndi mankhwala komanso omwe amakhalanso ndi nkhawa.
• RTMS yopezeka kuphatikiza ndi ECT ikhoza kuchepetsa kuchuluka kwa magawo a ECT ndikulola munthu kupeza chithandizo chamankhwala ndi rTMS atalandira chithandizo choyambirira cha ECT. Njira yothandizirayi ingathandize kuchepetsa zovuta za ECT.
• Kuwunikiranso mabuku mu 2019 komwe kunapezeka kuti rTMS ndi yothandiza pochiza mayeso atalandira mankhwala atagwira ntchito bwino pochiza vuto lalikulu lachisoni.

Kafukufuku ambiri omwe akuchitika pano ofufuza akuwunika zoyipa za rTMS ndikupeza kuti ndi mitundu iti yazizindikiro zomwe zimayankha bwino kuchipatala.