Zombili i-TMS kunye ne-ECT zingasetyenziselwa ukunyanga ukuxinezeleka okukhulu
UDkt. Kira Stein weeNtetho zeWestern Coast zeTMS kunye nomlobi uAndy Behrman malunga neyeza le-electroconvulsive (ECT), unyango oluqhelekileyo wokudakumba okukhulu kunye ne-transcranial magnetic stimulation (TMS), enye inyango yokudandatheka okukhulu. Qaphela ukuba uDkt. Stein uthetha ngezi zimbini zonyango ezinokubangela ukuxinezeleka okukhulu. Nangona kunjalo, i-ECT isetyenziselwa ukunyamezela ukuxinezeleka kwe-bipolar, mania , catatonia , kunye ne- schizophrenia , ukusebenzisa i-TMS kule miqathango ithathwa njenge-label-njengoko ingavunywanga yi-FDA.
Yintoni i-ECT kunye ne-TMS?
Andy Behrman: njani i-TMS isebenza ngokuhlukileyo kwi-electroshock therapy ( ECT )? Ziziphi iingenelo ze-TMS malunga neyeza kunye ne-ECT?
UDkt. Kira Stein: I- ECT isebenzisa ngokusebenzisa umbane wamandla ngokuthe ngqo kwintloko yesigulane ngelixa ikhutshwe kwaye ingenasiphelo, ngokwenza ngokubangela ukuba "ukuthathwa kweengxaki" ukuze kulungiswe ubuchopho. I-ECT inxulumene nemiphumo emfutshane yengqiqo edlalwa rhoqo, kodwa kungekho njalo, ikhusela ukuzimela ezizimeleyo ngeli xesha le-ECT linikezelwa.
Ezinye iziphumo ezichaphazelekayo ze-ECT ziquka intloko yesifo, imisipha yomzimba, isicupunu, ukutshintsha kwexesha elide kwisantliziyo senhliziyo, uxinzelelo lwegazi, kunye ne-arrhythmias esezantsi. Ukuphungulwa kweememori zesikhathi eside, nangona kungabalulekanga, kukho kwakhona inkcenkceshe ye-ECT. Ngenxa yoko, i-ECT ayifumaneki njengento yokuqala, yesibini, nokuba yinkqubo yesithathu yonyango, ngaphandle kweemeko ezinokutshatyalaliswa ngokukhawuleza kunye nokukhawuleza okuphazamisekayo, okanye ukuphazamiseka okunemiqondiso yengqondo.
Ubume kunye neengozi ze-ECT zivame ukuba izigulana zithathe ikhefu lesigxina emsebenzini kunye neengqondo zengqondo kwaye ziqeshe abazinakekeli okanye izibhedlele.
Ngokungafani ne-ECT, kunjalo, i-TMS ayifaki ukusetyenziswa kwamagunya ombane ngokuthe ngqo kwintloko yesigulane. I-TMS yenzelwe ukuba isebenzise inkqubo yokuphulukisa kwengqondo ngokunyamekela ngokumangalisayo ngokuvuselela inxalenye engacacileyo yengqondo xa igweba ukuxhatshazwa kwehlabathi jikelele kunye nokungaxilisi kwengqondo.
I-TMS ibandakanya imiphumo emibini, ngaloo ndlela yenza izigulane zihlale ziphaphile kwaye zikhululekile ngexesha lokwelashwa. Ukuvuselela kweMagnetic kwenza ukuba izigulane zihlale zizimeleyo, ziqhubeke nokusebenza rhoqo imihla kwaye zithathe inxaxheba kwimisebenzi yokukhuthaza ukuxoxwa, njengokwenziwa kwengqondo kunye nokuzivocavoca. Ezi zinto ziqhubekayo zinzima kakhulu ukwenza ngexesha le-ECT, kwaye abaninzi abantu baziva be-ECT kakhulu kakhulu kwiqondo leempawu eziphazamisayo .
Ukugqiba phakathi kweTMS kunye ne-ECT
U-Andy Behrman: I- ECT ibilokhu ibonwa njengeyokugqibela. Ngaba unomuvo wokugqibela wokuzama ukuzinzisa isigulane esinokudandatheka?
UDkt. Kira Stein: Nsuku zonke sifunda iindlela ezintsha kunye neendlela ezingcono zokuphatha uxinzelelo. Kuhlala kusekho ithemba, kwaye andizange ndithi kukho nayiphi na unyango "isigxina sokugqibela" sesigulane. I-psychotherapies ezintsha, amayeza, ubuchule bokuvuselela ubuchopho kunye nokunyusa okunesondlo kuphuhlisa lonke ixesha.
Ngelishwa, ukugqithisa nokunyaniseka kwe-ECT ngamaphephandaba kuye kwabangela izigulane ezinganyangekiyo kunye nezixinzelelekileyo ezichasayo, nangona xa iinzuzo ze-ECT zomeleleke kwi-80 ukuya kwe-90 yezinga lokuphendula kunye neendlela ezinokukhawuleza zokwenza ngokukhawuleza zicacise ngakumbi ingozi.
I-ECT yindlela ekhethekileyo kunye nefanelekileyo kwiigulane ezijongene neziganeko ezinzima kwaye ziyingozi zokungabandezeleka okanye ezingazange ziphendule-okanye zingenayo ixesha lokuphendula-unyango, i-TMS, okanye ezinye iindlela zokungenelela.
Andy Behrman: Ngaba i-TMS iyakucingwa ukuba izigulane ezingaphenduliyo kwi-ECT?
UDkt. Kira Stein: Ewe, abanye abantu abangazange baphendule kwi-ECT baye baboniswa ukuba baphendule kwi-TMS.
Indlela ye-ECT kunye ne-TMS Effect Your Brain
Andy Behrman: Injongo yamachiza kukuguqula ubuchopho bezobuchopho. Ngaba kulungile ukuba uthi ugesi okanye ukuvuselela magnetic kwenza into efanayo?
UDkt. Kira Stein: Kubonakala ukuba imichiza, i-TMS kunye ne-ECT konke ekugqibeleni kubangela utshintsho kumanqanaba e-neurotransmitter kunye nama-receptors, kunye namazinga akhulisiweyo okuphulukisa amaprotheni afana ne-brain-derived neurotrophic factor (BDNF).
I-correx ye-prefrontal iyaziwa ngokuba yinxalenye yengqondo kunye neyona ndlela ephezulu yokudibanisa ngokungavamile. Kucingelwa ukuba i-TMS ne-ECT igxininisa imisebenzi yomsebenzi we-lobe kunye nokuxhuma kunye nezakhiwo ezingundoqo zobomi. Nangona isiseko solwazi malunga nemiphumo yezokwelapha esakhulile kwiminyaka yakutshanje, kukho okungakumbi okufuneka sisifunde.
QAPHELA: Impendulo yodliwano-ndlebe lukaDkt. Stein iinjongo zolwazi jikelele kwaye ayihloselwe ukuba yingcali yonyango, yengqondo, okanye yezomthetho malunga nayiphi na imeko okanye umntu. Olu lwazi lujoliswe kubantu ngabanye kunye neentsapho zabo ukuba zisebenzise ngokubonisana nomsebenzi onoxanduva lwezempilo. UDkt. Stein akavumelekanga okanye enze nayiphi na imimiselo, kwaye akayivumeli nayiphi na imbopheleleko, malunga naluphi na unyango okanye isenzo ngumntu owenze izigqibo ngokusekelwe kwimiba evela kule ngxoxo.