Ukuphindaphinda Okukhuthazayo Magnetic Transcranial

-Delile

• Kungani i-rTMS isetshenziswa?
• Isebenza kanjani i-rTMS?
• Yimiphi imiphumela engemihle engaba khona kanye nezinkinga ze-rTMS?
• Ngabe ama-rTMS aqhathaniswa kanjani ne-ECT?
• Ngubani okufanele agweme ama-rTMS?
• Ziyini izindleko zama-rTMS?
• Yini ubude be-rTMS?
• Bathini ochwepheshe ngama-rTMS?

Lapho izindlela ezisekelwe emithini yokwelapha ukucindezeleka zingasebenzi, odokotela bangase banikeze ezinye izindlela zokwelashwa, njengokuphindaphinda okuphindaphindayo kwe-transcranial magnetic stimulation (rTMS).

Lokhu kwelashwa kubandakanya ukusebenzisa i-magnetic pulses ukukhomba izindawo ezithile zobuchopho. Abantu bebelokhu besebenzisa kusukela ngo-1985 ukukhulula ukudabuka okukhulu nemizwa yokuphelelwa yithemba okungaletha ukucindezeleka.

Uma wena noma othandekayo uzame izindlela eziningi zokwelashwa kwengcindezi ngaphandle kwempumelelo, i-rTMS ingaba yindlela.

Kungani i-rTMS isetshenziswa?

I-FDA ivume i-rTMS yokwelapha ukudangala okukhulu lapho ezinye izindlela zokwelapha (njengemithi nokwelashwa kwengqondo) zingatholanga umphumela owenele.

Kwesinye isikhathi, odokotela bangahlanganisa ama-rTMS nezindlela zokwelapha zendabuko, kufaka phakathi ama-anti-depressants.

Ungazuza kakhulu ku-rTMS uma uhlangabezana nale mibandela elandelayo:

• Uzame ezinye izindlela zokwelashwa kwengcindezi, okungenani eyodwa ye-antidepressant, ngaphandle kwempumelelo.
• Awunampilo enhle ngokwanele ngezinqubo ezifana ne-electroconvulsive therapy (ECT). Lokhu kuyiqiniso uma unomlando wokuquleka noma ungakwazi ukubekezelela i-anesthesia kahle yenqubo.
• Okwamanje awulwi nezinkinga zokusetshenziswa kwezidakamizwa noma kotshwala.

Uma lokhu kuzwakala njengawe, ungafisa ukukhuluma nodokotela wakho mayelana ne-rTMS. Kubalulekile ukuthi uqaphele ukuthi i-rTMS ayilona ukwelashwa komugqa wokuqala, ngakho-ke kuzofanele uzame ezinye izinto kuqala.

Isebenza kanjani i-rTMS?

Le yinqubo engahlaseli evame ukuthatha imizuzu engama-30 nengama-60 ukuyenza.

Nakhu ongakulindela esimisweni sokwelashwa esijwayelekile se-rTMS:

• Uzohlala noma uhlale lapho udokotela ebeka ikhoyili ekhethekile kagesi eduze kwekhanda lakho, ikakhulukazi indawo yobuchopho elawula imizwa.
• Ikhoyili ikhiqiza ukudonsa kwamandla kazibuthe ebuchosheni bakho. Umuzwa awubuhlungu, kepha ungazizwa ungqongqoza noma uthinta ikhanda.
• La mapulse akhiqiza imisinga kagesi kumaseli wakho ezinzwa.
• Ungaqala kabusha imisebenzi yakho ejwayelekile (kufaka phakathi ukushayela) ngemuva kwe-rTMS.

Kucatshangwa ukuthi le misinga kagesi ivuselela amangqamuzana obuchopho ngendlela eyinkimbinkimbi enganciphisa ukucindezeleka. Abanye odokotela bangafaka ikhoyili ezindaweni ezahlukahlukene zobuchopho.

Yimiphi imiphumela engemihle engaba khona kanye nezinkinga ze-rTMS?

Ubuhlungu akuvamisile ukuthi kube umphumela ohlangothini we-rTMS, kepha abanye abantu babika ukungakhululeki okuncane ngenqubo. Ama-pulses kagesi angadala imisipha ebusweni ukuqina noma ukuncinza.

Inqubo ihlotshaniswa nemiphumela emibi kuya kokumaphakathi, kufaka phakathi:

• imizwa yekhanda elincane
• izinkinga zokuzwa zesikhashana ngenxa yomsindo kazibuthe omkhulu kwesinye isikhathi
• ikhanda elincane
• ukuluma ebusweni, emhlathini noma ekhanda

Yize kuyivelakancane, ama-rTMS eza nengozi encane yokuquleka.

Ngabe ama-rTMS aqhathaniswa kanjani ne-ECT?

Odokotela banganikela ngezindlela zokwelapha eziningana zokukhuthaza ubuchopho ezingasiza ekwelapheni ukucindezeleka. Ngenkathi i-rTMS ingenye, enye i-electroconvulsive therapy (ECT).

I-ECT ifaka ukubeka ama-electrode ezindaweni ezingamasu zobuchopho nokukhiqiza amandla kagesi abangela ukuthi ukuqumba kwenzeke ebuchosheni.

Odokotela benza inqubo ngaphansi kwe-anesthesia ejwayelekile, okusho ukuthi ulele futhi awazi okuzungezile. Odokotela baphinde bakunikeze ukuphumula kwemisipha, okukugcina ungazanyazanyiswa ngesikhathi sengxenye yokwelashwa ekhuthazayo.

Lokhu kwehlukile kuma-rTMS ngoba abantu abathola i-rTMS akudingeki bathole imishanguzo yokuthambisa, enganciphisa ubungozi bemiphumela emibi engaba khona.

Omunye umehluko omkhulu phakathi kwalezi zinto yikhono lokukhomba izindawo ezithile zobuchopho.

Lapho ikhoyili ye-rTMS ibanjwe endaweni ethile yobuchopho, imizwa ihamba kuphela kuleyo ngxenye yobuchopho. I-ECT ayikhombi izindawo ezithile.

Ngenkathi odokotela besebenzisa i-rTMS ne-ECT ukwelapha ukudangala, i-ECT ivame ukubekelwa ukwelapha ukudangala okunzima futhi okungabeka impilo engcupheni.

Ezinye izimo nezimpawu odokotela abangasebenzisa i-ECT ukwelapha zifaka:

• ukuphazamiseka kwengqondo okuguquguqukayo
• schizophrenia
• imicabango yokuzibulala
• i-catatonia

Ngubani okufanele agweme ama-rTMS?

Ngenkathi i-rTMS ingenayo imiphumela emibi eminingi, kusenabantu abathile okungafanele bayithole. Awuyena umuntu ongenele ukhetho uma ufake insimbi noma ushumeke endaweni ethile ekhanda noma entanyeni yakho.

Izibonelo zabantu okungafanele bathole ama-rTMS zifaka phakathi labo abane:

• iziqeshana ze-aneurysm noma amakhoyili
• izingcezu zezinhlamvu noma isigaxa esiseduze nekhanda
• ama-pacemaker enhliziyo noma ama-defibrillator (ICD)
• ama-tattoos ebusweni anoyinki noma u-inki kazibuthe obuzwelayo kumazibuthe
• izivuseleli ezifakiwe
• ukufakelwa kwensimbi ezindlebeni noma emehlweni
• ama-stents entanyeni noma ebuchosheni

Udokotela kufanele enze ukuhlolwa okuphelele futhi athathe umlando wezokwelapha ngaphambi kokusebenzisa le ndlela yokwelapha. Kubaluleke ngempela ukudalula noma yiziphi zalezi zinto ezingaba yingozi ukukugcina uphephile.

Ziyini izindleko zama-rTMS?

Yize i-rTMS ibineminyaka engaphezu kwengu-30 ikhona, kusesekusha sha endaweni yokwelashwa kokudangala. Ngenxa yalokhu, awukho umzimba omkhulu wokucwaninga njengezinye izindlela zokwelashwa kokucindezeleka. Lokhu kusho ukuthi izinkampani zomshuwalense azikwazi ukumboza ukwelashwa kwe-rTMS.

Odokotela abaningi bazoncoma ukuthi uxhumane nenkampani yakho yomshuwalense ukuthola ukuthi ngabe bayayikhokha yini imishanguzo ye-rTMS. Impendulo ingaxhomeka kunqubomgomo yakho yezempilo neyomshuwalense. Kwesinye isikhathi, inkampani yakho yomshuwalense kungenzeka ingakhokhi zonke izindleko, kepha okungenani ikhokhe ingxenye ethile.

Ngenkathi izindleko zokwelashwa zingahluka ngokuya ngendawo, izindleko ezijwayelekile zingasukela kuseshini ngayinye yokwelashwa.

I-Medicare imvamisa ibuyisa ama-rTMS ngokwesilinganiso se-. Umuntu angaba nezikhathi zokwelashwa kusuka kuma-20 kuye kwangama-30 noma ngaphezulu ngonyaka.

Olunye ucwaningo luphakamisa ukuthi umuntu angakhokha phakathi kuka- $ 6,000 no- $ 12,000 ngonyaka ngemithi yokwelashwa yama-rTMS. Ngenkathi leli nani lentengo lingabonakala liphezulu uma kucatshangelwa unyaka ngesikhathi, ukwelashwa kungabiza kakhulu uma kuqhathaniswa nokusebenzisa ezinye izindlela zokwelapha ezingasebenzi kahle.

Ezinye izibhedlela, amahhovisi odokotela, nezindawo zokunakekelwa kwezempilo zinikela ngezinhlelo zokukhokha noma izinhlelo ezinesaphulelo zalabo abangakwazi ukukhokha yonke imali.

Yini ubude be-rTMS?

Odokotela bazokwenzela umuntu incwadi kadokotela uma kuziwa ekwelashweni. Kodwa-ke, iningi labantu lizoya ezikhathini zokwelashwa ezihlala noma kuphi kusuka kumaminithi angama-30 kuye kwangama-60 cishe izikhathi ezinhlanu ngesonto.

Isikhathi sokwelashwa ngokuvamile sihlala phakathi kwamaviki amane kuya kwayisithupha. Leli nani lamasonto lingaba mfushane noma lide kuye ngempendulo yomuntu ngamunye.

Bathini ochwepheshe ngama-rTMS?

Izilingo eziningi zocwaningo nezibuyekezo zomtholampilo zibhaliwe kuma-rTMS. Eminye imiphumela ifaka phakathi:

• Ucwaningo lwango-2018 luthole ukuthi abantu abaphendule kuma-rTMS ngokwandisa umsebenzi wabo we-theta ne-alpha brainwave kungenzeka bathuthukise imizwa yabo. Lolu cwaningo lomuntu oluncane lungasiza ukubikezela ukuthi ngubani ongaphendula kakhulu kuma-rTMS.
• Kutholakale ukuthi ukwelashwa kufanelekile kulabo abanokudangala okungazweli emithini futhi abanokukhathazeka okukhulu.
• Ama-rTMS atholakele ahlanganiswe ne-ECT anganciphisa inani lezikhathi ze-ECT ezidingekayo futhi avumele umuntu ukuthi athole ukwelashwa kwesondlo nge-rTMS ngemuva komjikelezo wokuqala wokwelashwa kwe-ECT. Le ndlela yokuhlanganisa ingasiza ukunciphisa imiphumela emibi ye-ECT.
• Ukubuyekezwa kwezincwadi zango-2019 kutholakale ukuthi i-rTMS iyasebenza ekwelashweni ngemuva kokuthi isilingo semithi esisodwa sisebenze kahle ekwelapheni ukucindezeleka okukhulu.

Izifundo eziningi eziqhubekayo manje zinabacwaningi abahlola imiphumela yesikhathi eside ye-rTMS nokuthola ukuthi yiziphi izinhlobo zezimpawu ezisabela kahle ekwelashweni.