Kudzokorora Transcranial Magnetic Kukurudzira

Zvemukati

• Nei rTMS ichishandiswa?
• RTMS inoshanda sei?
• Ndezvipi zvinokanganisa mhedzisiro uye kuomarara kweRTMS?
• RTMS inofananidzwa sei neECT?
• Ndiani anofanirwa kudzivirira rTMS?
• Ndezvipi zvinodhura zveRTMS?
• Ndeipi nguva yeRTMS?
• Chii icho nyanzvi dzinoti nezve rTMS?

Kana mishonga-yakavakirwa nzira yekurapa kushushikana isiri kushanda, vanachiremba vanogona kupa mamwe marapirwo, akadai sekudzokorora transcranial magnetic kukurudzira (rTMS).

Iyi kurapa inosanganisira kushandisa magineti pulses kunongedza chaiko nzvimbo dzehuropi. Vanhu vanga vachirishandisa kubvira 1985 kudzora kusuwa kwakanyanya uye nemanzwiro ekushaya tariro anogona kuuya nekushungurudzika.

Kana iwe kana munhu waunoda akaedza nzira dzinoverengeka dzekurapwa kwekushushikana pasina kubudirira, rTMS inogona kunge iri sarudzo.

Nei rTMS ichishandiswa?

Iyo FDA yakabvumidza rTMS kurapa kushushikana kwakanyanya apo kumwe kurapwa (senge mishonga uye psychotherapy) isina kubudirira zvakakwana.

Dzimwe nguva, vanachiremba vanogona kusanganisa rTMS nemishonga yechinyakare, kusanganisira mishonga yekudzvinyirira.

Unogona kubatsirwa zvakanyanya kubva kuRTMS kana ukasangana nezvinotevera nzira:

• Wakaedza dzimwe nzira dzekurapa kushushikana, senge imwechete yekudzvinyirira, pasina kubudirira.
• Iwe hausi mune hutano hwakakwana zvakakwana kune maitiro senge electroconvulsive therapy (ECT). Izvi ichokwadi kana iwe uine nhoroondo yekubatwa kana kusakwanisa kushivirira anesthesia zvakanaka maitiro.
• Hausi parizvino uri kunetsekana nezvinhu zvekushandisa kana doro.

Kana izvi zvichirira senge iwe, iwe ungashuve kutaura nachiremba wako nezve rTMS. Izvo zvakakosha kuti uzive kuti rTMS haisi yekutanga mutsara kurapwa, saka uchafanirwa kuedza zvimwe zvinhu kutanga.

RTMS inoshanda sei?

Iyi ndiyo nzira isingafadzi iyo inowanzo kutora pakati pemaminitsi makumi matatu nemakumi matanhatu kuti iite.

Hezvino izvo zvaunogona kutarisira pane yakajairwa rTMS kurapwa chikamu:

• Iwe uchagara kana kutsenhama apo chiremba anoisa yakakosha yemagetsi coil padyo nemusoro wako, kunyanya nzvimbo yehuropi inodzora manzwiro.
• Iyo coil inogadzira magineti pulses kuuropi yako. Kunzwa kwacho hakurwadze, asi kunogona kuita sekugogodza kana kurova musoro.
• Iyi pulses inogadzira magetsi emagetsi mumasero ako etsinga.
• Unogona kutangazve zviitiko zvako zvenguva dzose (kusanganisira kutyaira) mushure meRTMS.

Zvinofungidzirwa kuti aya magetsi emagetsi anomutsa maseru ehuropi nenzira yakaoma iyo inogona kudzikisa kushushikana. Vamwe vanachiremba vanogona kuisa coil munzvimbo dzakasiyana dzehuropi.

Ndezvipi zvinokanganisa mhedzisiro uye kuomarara kweRTMS?

Marwadzo haawanzo kuve nemhedzisiro mhedzisiro yeRTMS, asi vamwe vanhu vanotaura kusagadzikana kuderera nemaitiro acho. Magetsi emagetsi anokonzeresa anogona kukonzera mhasuru kumeso kuti dzisimbe kana kugwinha.

Maitiro acho anosanganisirwa nehuremu uye zvine mwero mhedzisiro, inosanganisira:

• manzwiro ehumusoro
• matambudziko ekunzwa kwenguva pfupi nekuda kwerimwe ruzha magineti ruzha
• kutemwa nemusoro
• kurira kumeso, shaya, kana ganda romusoro

Kunyangwe zvisingawanzoitika, rTMS inouya nenjodzi diki yekubatwa.

RTMS inofananidzwa sei neECT?

Vanachiremba vanogona kupa akati wandei ekurudzira ekurapa marapirwo ayo anogona kubatsira kubata kushungurudzika. Ipo rTMS iri imwe, imwe inonzi electroconvulsive therapy (ECT).

ECT inosanganisira kuisa ma electrode munzvimbo dzakakosha dzehuropi uye kugadzira magetsi emagetsi anokonzeresa kuti kubatwa kuitike muuropi.

Vanachiremba vanoita maitiro pasi peanesthesia, zvinoreva kuti iwe wakarara uye hauzive zvakakukomberedza.Vanachiremba zvakare vanokupa iwe mhasuru inozorodza, iyo inokuchengetedza iwe kuti usazununguke panguva yekukurudzira chikamu chekurapa.

Izvi zvinopesana neRTMS nekuti vanhu vanogamuchira rTMS havafanirwe kuwana mishonga yekunyaradza, izvo zvinogona kudzikisira njodzi dzingave nemhedzisiro.

Imwe yemamwe misiyano yakakosha pakati pezviviri kugona kunongedza dzimwe nzvimbo dzehuropi.

Kana rTMS coil ikabatwa pamusoro peimwe nzvimbo yeuropi, mafambiro anofamba chete kune iyo chikamu chehuropi. ECT haina kunanga nzvimbo dzakananga.

Nepo vanachiremba vachishandisa zvese rTMS uye ECT kurapa kushushikana, ECT inowanzo chengeterwa kurapa zvakakomba uye zvinogona kutyisidzira hupenyu kuora mwoyo.

Mimwe mamiriro uye zviratidzo vanachiremba vanogona kushandisa ECT kurapa vanosanganisira:

• bipolar kusagadzikana
• schizophrenia
• pfungwa dzekuzviuraya
• catatonia

Ndiani anofanirwa kudzivirira rTMS?

Nepo rTMS isina yakawanda mhedzisiro, kuchine vamwe vanhu vasingafanire kuitora. Iwe hausi mukwikwidzi kana iwe uine simbi yakaiswa kana kusimbwa kumwe kunhu mumusoro kana mutsipa.

Mienzaniso yevanhu vasingafanire kuwana rTMS inosanganisira avo vane:

• aneurysm clip kana machira
• zvidimbu zvebara kana shrapnel padyo nemusoro
• cardiac pacemaker kana inogadzirirwa cardioverter defibrillators (ICD)
• kumeso matatto ane magnetic inki kana inki inoteerera kune magetsi
• akaisirwa zvinokurudzira
• midziyo yesimbi munzeve kana mumaziso
• kunhuwa mumutsipa kana muhuropi

Chiremba anofanira kuitisa bvunzo yakakwana uye kutora nhoroondo yezvokurapa asati ashandisa kurapwa. Zvakakosha chaizvo kuburitsa chero izvi zvinogona kuisa njodzi kukuchengetedza.

Ndezvipi zvinodhura zveRTMS?

Kunyangwe rTMS yave iripo kweanopfuura makore makumi matatu, ichiri nyowani nyowani kune yekuora mwoyo nzvimbo yekurapa. Nekuda kweizvozvo, hapana rakakura seboka rekutsvagisa semamwe marapirwo ekuora mwoyo. Izvi zvinoreva kuti makambani einishuwarenzi anogona kunge asingavhare rTMS kurapwa.

Vanachiremba vazhinji vanokurudzira kuti ubate kambani yako yeinishuwarenzi kuti uone kana vachivhara marapirwo eRTMS. Mhinduro yacho inoenderana nehutano hwako neinishuwarenzi. Dzimwe nguva, yako inishuwarenzi kambani inogona kusabhadhara zvese zvinodhura, asi zvirinani kubhadhara chikamu.

Nepo mutengo wekurapa ungasiyana zvichienderana nenzvimbo, avhareji yemitengo inogona kutangira kubva pane imwe nguva yekurapa.

Medicare inowanzo dzosera rTMS paavhareji ye. Munhu anogona kunge aine chero kubva pamakumi maviri kusvika makumi matatu kana anopfuura masangano ekurapa pagore.

Imwe ongororo inoratidza kuti munhu anogona kubhadhara pakati pemadhora zviuru zvitanhatu kusvika pamadhora zviuru gumi nemaviri pagore kurapa kweTMMS. Kunyange hazvo mutengo wemutengo uyu ungaratidzika kunge wakakwirira kana uchifunga gore panguva, kurapwa kwacho kunogona kudhura kana uchienzaniswa nekushandisa mamwe marapirwo ekushushikana asingashande zvakanaka.

Zvimwe zvipatara, mahofisi echiremba, uye nzvimbo dzehutano dzinopa zvirongwa zvekubhadhara kana zvakaderedzwa zvirongwa kune avo vasingakwanise kubhadhara iyo yose mari.

Ndeipi nguva yeRTMS?

Vanachiremba vanogadzira imwe tsamba yemunhu kana zvasvika pakurapwa. Nekudaro, vanhu vazhinji vanozoenda kumisangano yekurapa iyo inogara chero kubva pamakumi matatu kusvika makumi matanhatu maminetsi ingangoita ka5 pasvondo.

Iyo yekurapa nguva inowanzo kutora pakati pe4 ne6 mavhiki. Iyi nhamba yemavhiki inogona kupfupika kana kureba zvichienderana nemhinduro yemunhu.

Chii icho nyanzvi dzinoti nezve rTMS?

Yakati wandei miedzo yekutsvagisa uye kuongororwa kwekiriniki zvakanyorwa pane rTMS. Mimwe mhedzisiro yacho inosanganisira:

• Chidzidzo che2018 chakawana kuti vanhu vakapindura maRTMS nekuwedzera kwavo theta uye alpha brainwave chiitiko vaigona kuita kuti vagadzirise mafungiro avo. Ichi chidzidzo chidiki chevanhu chingabatsira kufembera kuti ndiani angazopindura zvakanyanya kuTMM.
• A yakawanikwa kurapwa kwakakodzera kune avo vane kushushikana kuri kusagadzikana nemushonga uye vane zvakare kwakanyanya kunetsekana.
• RTMS yakawanikwa yakabatana neECT inogona kudzikisira huwandu hweanodiwa eECT zvikamu uye inobvumira munhu kuwana kurapwa kwekuchengetedza neRTMS mushure mekutanga kwekurapwa kweECT. Iyi nzira yekubatanidza inogona kubatsira kudzikisira mhedzisiro yeECT.
• Ongororo yemabhuku e2019 yakawanikwa rTMS inoshanda pakurapa mushure mekumwe kuyedzwa kwemushonga kwakashanda zvakanaka mukurapa kushushikana kukuru kwekushushikana.

Zvakawanda zvidzidzo zvino zviri kuenderera mberi vaongorori vachiongorora mhedzisiro-yenguva refu mhedzisiro yeRTMS uye nekuona kuti ndeapi marudzi ezviratidzo anopindura zvakanyanya kurapwa