rTMS

Repetitive transkranielle elektromagnetische Hirnstimulation (rTMS), sicher, schonend, nachhaltig wirksam

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Vorteile einer rTMS-Behandlung

Das Neuromodulationsverfahren rTMS (repetitive transkranielle elektromagnetische Hirnstimulation) hat sich erwiesen als eine sichere und effektive Behandlungsform, das zunächst bei der Depressionstherapie eingesetzt wurde. Später wurde es auch bei anderen psychogenen Erkrankungen eingesetzt: bei Angst, Zwängen, Depersonalisation und Derealisation sowie bei bipolaren Störungen. Es kamen chronische Schmerzerkrankungen hinzu, bei denen an anderen Stimulationsorten, mit anderen Intensitäten und Protokollen gearbeitet werden muss: bei Fibromyalgie, bei CRPS und anderen neuropathischen Schmerzen, bei Phantomschmerzen und bei Migräne.

Neuromodulation wirkt lokal, nicht systemisch und zeigt keine der Nebenwirkungen [1], die typischerweise bei Antidepressiva auftreten. Der häufigste Nebeneffekt der rTMS ist eine moderate auf den Behandlungsbereich lokalisierte Missempfindung der Kopfhaut, die gut toleriert wird, ohne Therapie abklingt und von Anwendung zu Anwendung nachlässt. Das Risiko eines Krampfanfalls liegt bei unter 0,1% (insgesamt wurden weltweit nur maximal 12 dieser Ereignisse registriert) und wird durch Einhaltung der Gegenanzeigen und des Sicherheitsprotokolls (Wassermann 1996, Rossi 2006) noch weiter minimiert.

Neuromodulationspatienten sind wach, ansprechbar und unbeeinträchtigt, sodass sie nach der Behandlungs-Sitzung ihren normalen alltäglichen Aktivitäten nachgehen können. Beachten Sie bitte auch die Informationen unter den häufig gestellten Fragen (FAQ).

Gegenanzeigen

  • erhöhter Hirndruck (der die Krampfschwelle senkt)
  • Epilepsie in der persönlichen oder familiären Vorgeschichte
  • Einnahme von psychotropen Substanzen (Amphetamin, Kokain)
  • Einnahme von Krampfschwelle-senkenden Substanzen (Lokalanästhetika, Cortison, Alkohol)
  • Schlafentzugsbedingungen
  • Auffälligkeiten im Gehirn-MRT in der Vorgeschichte
  • Metall im Kopf (außer im Mund), z.B. Innenohrimplantate, implantierte Neurostimulatoren, Aneurysma-Clips
  • Schlaganfall oder Kopf- und Hirnverletzungen in der Vorgeschichte
  • Neurochirurgische Eingriffe an Schädel oder Gehirn in der Vorgeschichte
  • schwere Kopfschmerzen
  • implantierte Herzschrittmacher und Defibrillatoren
  • Bedeutsame Herzerkrankungen oder Herzinfarkt in der Vorgeschichte
  • implantierte Medikamentenpumpen (externe Pumpen sind kein Problem)
  • Patienten mit Cochlea-Implantaten (Hörgeräte kein Problem)
  • Schwangere/Stillende (obgleich Kasuistiken ohne Probleme beschrieben sind)
  • Kinder und Heranwachsende

Sicherheit [2-8]

Im Rahmen von dokumentierten klinischen Untersuchungen und Studien wurden über 10.000 Patienten hinsichtlich Nebenwirkungen untersucht und befragt. Dabei zeigte sich die gute Verträglichkeit und Sicherheit von rTMS: es kam zu keinem einzigen Krampfanfallsereignis und zu keinen systemischen Nebenwirkungen, Gedächtnis und Konzentrationsfähigkeit blieben unbeeinträchtigt. Die statistische Wahrscheinlichkeit für einen Krampfanfall liegt bei 1:30.000 Anwendungen bzw. 1:1000 Patienten und wird noch weiter verbessert durch Einhaltung des erweiterten Sicherheitsprotokolls.

rTMS-Indikationen und Wirksamkeitsnachweise

  • Depressionen [9-32]
  • Somatisierte Depression [33]
  • Ängste [21, 31]
  • Depersonalisation [34-37]
  • Zwänge [38-47]
  • Posttraumatische Belastungsstörung PTBS [9, 21, 48-51]
  • Phantomschmerz [52]
  • Rückenschmerz – back pain [53]
  • Chronischer unspezifischer Schmerz [54-75]
  • Neuropathischer Schmerz [76-94]
  • Kopfschmerzen undifferenziert [95, 96]
  • Migräne [97-106]
  • Cluster Headache [107-109]
  • Rheuma [110]
  • Fibromyalgie [111-123]
  • Central Pain [83, 124-127]
  • CRPS [128-130]
  • Deafferentierungsschmerz [131, 132]
  • Muskelschmerzen [133]
  • Postzoster-Radikulopathie [134]
  • Burning mouth syndrome [135]
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