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강박장애에 대한 경두개 직류자극술의 적용
Application of Transcranial Direct Current Stimulation in Obsessive-Compulsive Disorder 원문보기

Anxiety and mood = 대한불안의학회지, v.17 no.1, 2021년, pp.1 - 11  

부영준 (공군교육사령부 기지병원) ,  김세주 (연세대학교 의과대학 정신과학교실, 의학행동과학연구소)

초록
AI-Helper 아이콘AI-Helper

본 종설에서는 현재까지 진행된 강박장애에서의 tDCS의 임상연구에 대하여 체계적으로 고찰하였다. tDCS는 비침습적이고 비교적 안전한 치료법으로, 치료 저항성을 보이는 강박장애 환자를 대상으로 적용한 다수의 실험 연구 및 사례 보고에서 중대한 이상반응 없이 치료 효과를 나타내었다. 다만 최근 연구에 따르면 치료저항성이 없는 환자에 대해 기존 치료를 대체할 수 있는 수준의 효과를 보이지는 못했으므로, 치료저항성이 없는 환자에서 어느 정도의 효과를 보일 것인지에 대해서는 추가적인 연구가 필요할 것으로 보인다. 강박장애 치료에 있어서 tDCS 활용의 프로토콜은 완전히 정립되지는 않았다. 현 시점까지 출판된 문헌을 토대로 분석하였을 때 대부분의 연구는 2 mA, 세션당 20~30분, 총 10~20 세션으로 이루어졌다. 최근 출판된 근거-기반 tDCS 치료지침에서는 양극 pre-SMA tDCS를 다른 방법보다 우선 채택하였으나, 그 극성에 따른 효과는 아직 논란의 여지가 있는 것으로 보인다. 다만, 해당 치료지침에 포함된 연구 이후에 다수의 RCT 연구들이 출판되었으므로, 연구 결과들을 종합해보면 pre-SMA를 표적으로 한 양극 tDCS 외에 좌측 OFC에 대한 음극 tDCS도 치료 방식의 후보로서 고려를 해볼 수 있을 것으로 보인다. 그 외 DLPFC와 소뇌 등도 tDCS의 표적 위치로 연구된 바가 있어 추가적인 연구가 필요할 것으로 생각된다. 현재까지 진행된 연구를 바탕으로 더욱 더 많은 연구가 진행된다면 tDCS가 추후 치료 저항성 강박장애 환자에서 시도될 수 있는 치료법 중 하나로 정립될 수 있는 가능성이 높을 것으로 기대된다.

Abstract ▼ AI-Helper 아이콘AI-Helper

Treating obsessive-compulsive disorder (OCD) is a difficult challenge since less than a half of the OCD patients show a significant treatment response to 1st line treatment. Therefore, various treatment tools including brain stimulation methods have been studied to solve the treatment-resistance of ...

주제어

#강박장애   #경두개 직류자극술   #비침습적 뇌자극 치료  

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