Оценка эффективности терапии мигрени с использованием функциональной магнитно-резонансной томографии покоя при курсовой ритмической транскраниальной магнитной стимуляции

Обоснование: в условиях поиска новых возможностей терапии мигрени требуется строгий контроль их эффективности с помощью объективных методов обследования.

Цель исследования. Объективная оценка эффективности транскраниальной магнитной стимуляции (ТМС) у пациентов с мигренью на основе данных функциональной магнитно-резонансной томографии (фМРТ).

Материал и методы. У 19 пациентов с мигренью была выполнена фМРТ в состоянии покоя до и после пятидневного курса терапии ТМС стыка нижнелобной и височной долей билатерально. Изменения функциональной коннективности (ФК) основных нейрональных сетей головного мозга, а также клинические показатели боли и качества жизни пациентов оценивались до и после проведенного курса ТМС.

Результаты. На фоне терапии наблюдалось снижение показателей интенсивности боли и тревоги, а также уменьшение количества принимаемых лекарств от острой боли. Изменения ФК затронули три основные сети: сеть пассивного режима работы мозга, сеть выявления значимости и зрительную сеть. При этом сниженная эффективность терапии отмечалась у пациентов с более высоким уровнем выраженности депрессивных симптомов и наличием нейровизуализационных критериев депрессии.

Заключение. Исследование позволяет предположить об эффективности применения ТМС у пациентов с мигренью на основе нейровизуализации. Стоит обращать особое внимание на наличие депрессивной симптоматики у пациентов с мигренью.

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