Ni iki Gushishikariza Ubwonko hifashishije Amashanyarazi? Intego, Uburyo & Ibivamo

Gushishikariza Ubwonko hifashishije Amashanyarazi (TMS) ni uburyo bwo kuvura butagira ingaruka ku bwonko bukoresha imiraba ya magneti kugira ngo bukangure ahantu runaka mu bwonko bwawe. Bitekereze nk'uburyo bworoshye bwo "gukangura" uturere tw'ubwonko tutagikora neza, cyane cyane mu bibazo nka depression aho imiterere y'ubwonko imwe igabanuka.

Ubu buryo bwo kuvura bwemewe na FDA bumaze gufasha abantu kubona uburinzi ku bibazo bitandukanye byo mu mutwe kuva mu 2008. Ubu buryo bukorwa mu biro bya muganga mugihe uri maso kandi witeguye, bigatuma buba uburyo bworoshye cyane ugereranije n'ubundi buryo bwo kuvura bukomeye.

Ni iki Gushishikariza Ubwonko hifashishije Amashanyarazi?

TMS ikora mugushyira ikintu gisa n'uruziga rwa magneti ku mutwe wawe kugira ngo itange imiraba ya magneti yibanda ku turere tw'ubwonko runaka. Iyi miraba isa n'imbaraga zikoreshwa mu mashini ya MRI, ariko zigamije gushishikariza imitsi y'ubwonko ahantu hagenzura imyumvire, gutekereza, n'imyitwarire.

Imiraba ya magneti inyura mu gihanga cyawe itagufashe, kandi ikarema amashanyarazi mato mu gice cy'ubwonko bwawe. Aya mashanyarazi afasha "gusubiza" inzira z'imitsi y'ubwonko zishobora kuba zarahungabanye kubera depression, umunabi, cyangwa ibindi bibazo.

Hariho ubwoko bubiri bw'ingenzi ushobora guhura nabwo. Repetitive TMS (rTMS) itanga imiraba isanzwe mu buryo bukurikirana, mugihe theta burst stimulation itanga imiraba migufi, ikomeye cyane. Muganga wawe azahitamo uburyo bukwiye cyane kubibazo byawe byihariye.

Kuki Gushishikariza Ubwonko hifashishije Amashanyarazi bikorwa?

TMS ikoreshwa cyane cyane iyo uburyo bwo kuvura busanzwe butatanze uburinzi buhagije ku bimenyetso byawe. Ikoreshwa cyane cyane mu kuvura depression irwanya imiti, bivuze ko wagerageje nibura imiti ibiri itandukanye yo kurwanya depression ntigire icyo igeraho.

Uretse agahinda gakabije, TMS ishobora gufasha mu bindi bibazo byinshi bigira ingaruka ku mibereho yawe. Muganga wawe ashobora kuyigushyiriraho kubera indwara yo kwigunga (OCD), cyane cyane iyo ibitekerezo byinjira n'imyitwarire yo kwigunga bikomeza nubwo hakoreshejwe izindi nshuti.

Ubu buvuzi kandi burimo gukoreshwa mu kurwanya umutwe ukabije, cyane cyane ku bantu bahura n'umutwe ukabije kenshi kandi ubabuza gukora. Abantu bamwe barasanga TMS ifasha mu bibazo byo guhangayika, indwara yo guhangayika nyuma y'ihungabana (PTSD), ndetse no mu bibazo bimwe na bimwe by'ububabare.

Mu bihe bidasanzwe, TMS ishobora gutekerezwa ku bibazo nk'indwara ya bipolar, schizophrenia, cyangwa indwara zo kurya, nubwo izi nshuti zigikorwaho ubushakashatsi. Umuganga wawe azasuzuma neza niba TMS ikwiriye kubera uko ubuzima bwawe buhagaze.

Ni iki gikorerwa Transcranial Magnetic Stimulation?

Icyiciro cyawe cya mbere cya TMS kizaba kirekire kurusha uko bisanzwe kuko muganga wawe akeneye gushushanya ubwonko bwawe no gushaka imbaraga zikwiriye zo gutera. Uzicara ku ntebe yoroshye mugihe umukanishi ashyira ikintu gifite magneti ku mutwe wawe, akenshi hejuru y'uruhu rwo mu mutwe rwa prefrontal.

Uburyo bwo gushushanya burimo gushaka “motor threshold” yawe - umubare muto wo gutera magneti ukenewe kugirango igikumwe cyawe gihinduke gato. Ibi bifasha kumenya neza ko wakira urugero rukwiye rw'imiti kubera imiterere yihariye y'ubwonko bwawe.

Mugihe cyo kuvura buri gihe, uzumva amajwi yo gukanda mugihe imbaraga za magneti zoherezwa. Ibi byiciro bikunze kumara iminota 20 kugeza kuri 40, kandi urashobora gusoma, kumva umuziki, cyangwa kuruhuka gusa. Abantu benshi basobanura icyiyumvo nk'icyo kumva nk'aho bakomerwa gahoro ku mutwe wabo.

Uburyo busanzwe bwa TMS bukubiyemo imiti ya buri munsi iminsi itanu mu cyumweru mu byumweru bine kugeza kuri bitandatu. Ibi bivuze ko ushobora kugira ibyiciro 20 kugeza kuri 30 byose, nubwo abantu bamwe bungukira mu byiciro byo gukomeza nyuma.

Ubuvuzi bukorwa umuntu atari mu bitaro, bityo ushobora kwitwara mu gihe ujya no mu gihe ugaruka mu gihe cyo guhura na muganga. Bitandukanye n'ubundi buryo bumwe bwo kuvura ubwonko, TMS ntisaba kubagwa cyangwa gutuza, bigatuma ukomeza imirimo yawe ya buri munsi.

Uburyo bwo kwitegura kuvurwa na Transcranial Magnetic Stimulation?

Kwitegura TMS biroroshye, ariko hari intambwe z'ingenzi zo kureba umutekano wawe n'imikorere y'ubuvuzi. Muganga wawe azabanza gukora isuzuma ryimbitse ry'ubuvuzi, harimo ibibazo bijyanye n'ibintu byose by'icyuma byashyizwe mu mubiri, ibikoresho by'ubuvuzi, cyangwa imiti urimo gufata.

Uzagomba gukuraho ibintu byose by'icyuma mu mutwe wawe no mu gice cy'ijosi mbere ya buri gihe cyo kuvurwa. Ibi birimo imitako, imisatsi, ibikoresho byo kumva, n'imirimo yo mu kanwa ikurwaho. Ibi bintu bishobora kubangamira imbaraga za magneti cyangwa bigashyuha mu gihe cyo kuvurwa.

Menyesha ikipe yawe y'ubuzima imiti yose urimo gufata, cyane cyane iyo igabanya urugero rwawe rwo gufatwa n'indwara. Nubwo gufatwa n'indwara ari gake cyane kuri TMS, imiti imwe irashobora kongera gato iyi ngaruka. Muganga wawe ashobora guhindura imiti yawe by'agateganyo niba bibaye ngombwa.

Ku munsi wo kuvurwa, fungura neza kandi unywe amazi ahagije. Urashobora gushaka kuzana ama-headphone cyangwa ibiziba amatwi, kuko amajwi yo gukanda ashobora kumvikana cyane, nubwo amavuriro menshi atanga uburinzi bw'amatwi. Abantu bamwe babona ko bifasha kuzana igitabo cyangwa umuzika kugirango bafashe kwica igihe mu gihe cyo kuvurwa.

Niba ufite impungenge zerekeye claustrophobia cyangwa guhangayika ku bijyanye n'iyi nzira, biganire n'ikipe yawe y'ubuvuzi mbere y'igihe. Bashobora kugufasha kumva umeze neza kandi bashobora gutanga ibitekerezo byo kuruhuka.

Uburyo bwo gusoma ibisubizo byawe bya Transcranial Magnetic Stimulation?

Ibisubizo bya TMS ntibipimwa binyuze mu bizami bisanzwe byo mu laboratwari cyangwa inyigo z'amashusho. Ahubwo, iterambere ryawe risuzumwa binyuze mu bipimo byo gupima ibimenyetso, ibibazo by'amarangamutima, no gusuzuma buri gihe n'umuganga wawe ku bijyanye n'uko wumva umeze.

Ushobora gutangira kubona impinduka mu myumvire yawe, urwego rw'imbaraga, cyangwa ibindi bimenyetso nyuma y'ibyumweru bibiri cyangwa bitatu uvurwa. Abantu bamwe bahura n'impinduka zigenda buhoro buhoro, mu gihe abandi babona impinduka zihuse. Zombi ni ibisanzwe kandi ntibigaragaza uko bizagenda.

Muganga wawe ashobora gukoresha ingero zigenewe kugenzura agahinda cyangwa umunabi kugira ngo akurikirane iterambere ryawe mu buryo bugaragara. Ibi bibazo bifasha gupima impinduka mu gusinzira, ubushake bwo kurya, kwibanda, n'imyumvire muri rusange ushobora kutabona umunsi ku wundi.

Uburyo TMS ikora busanzwe busobanurwa nk'uko ibimenyetso byiyongera ku kigero cya 50% cyangwa hejuru, mu gihe gukira bisobanura ko ibimenyetso byawe byagabanutse ku rwego ruto. Abantu bagera kuri 60% bahura n'iterambere ririgaragaza, kandi hafi kimwe cya gatatu kigakira.

Wibuke ko inyungu zishobora gukomeza kwiyongera mu byumweru byinshi nyuma y'uko urugendo rwawe rwo kuvurwa rurangira. Abantu bamwe babona ibisubizo byiza nyuma y'ukwezi kumwe cyangwa kugeza kuri bitatu nyuma yo kuvurwa, bityo kwihangana ni ingenzi muri uru rugendo.

Ni gute wakongera umusaruro wawe wa Transcranial Magnetic Stimulation?

Kongera inyungu zawe za TMS bikubiyemo gukurikiza gahunda yawe yo kuvurwa no gushyigikira ubuzima bwawe bwo mu mutwe muri rusange. Kuditabira amasomo bishobora kugabanya imikorere yo kuvura, bityo gerageza kwitabira inama zose zateganyijwe kabone n'iyo utumva impinduka zihuse.

Komeza gufata imiti yose yanditswe keretse muganga wawe abigushishikarije. TMS akenshi ikora neza iyo ihujwe n'imiti igabanya agahinda cyangwa indi miti usanzwe ufata. Ntuzahagarike cyangwa ngo uhindure imiti utabanje kubiganiraho n'umuganga wawe.

Gushyigikira kuvurwa kwawe n'ubuzima bwiza bushobora kongera ibisubizo byawe. Imyitozo ngororamubiri ya buri gihe, gusinzira bihagije, n'imirire myiza byose bishyigikira ubuzima bw'ubwonko kandi bishobora gufasha TMS gukora neza. N'ibikorwa byoroheje nko kugenda birashobora kugira akamaro.

Tekereza kongeramo psychothérapie mu gahunda yawe y'imiti niba utarakorana n'umuvuzi. Abantu benshi basanga TMS ibagira abakira cyane kuri therapy, kandi ubu buryo buvanze akenshi butanga ibisubizo byiza kurusha uburyo bumwe.

Guma mu mubano n'abantu bagushyigikiye mu gihe cyose cy'imiti. Menyesha umuryango n'inshuti urugendo rwawe rwa TMS kugira ngo baguhe inkunga kandi bagufashe kubona impinduka nziza ushobora kutabona.

Ni ibihe bintu byongera ibyago byo kugira ingaruka ziterwa na TMS?

Abantu benshi boroherwa na TMS cyane, ariko ibintu bimwe na bimwe bishobora kongera ibyago byo kugira ingaruka cyangwa bikagutera kutemerewa gukoresha ubu buryo. Kugira ibikoresho by'icyuma mu mutwe wawe cyangwa hafi yawo ni ikintu cy'ingenzi cyongera ibyago, kuko bishobora gushyuha cyangwa kwimuka mu gihe cy'imiti.

Ibintu by'icyuma byihariye bituma TMS idatekanye birimo ibikoresho byo kumva (cochlear implants), ibikoresho byo gushishikariza ubwonko (deep brain stimulators), ibikoresho byo gushishikariza imitsi ya vagus, n'ubwoko bumwe na bumwe bw'ibikoresho byo gufunga aneurysm. Ariko, ibyuzuzo byo mu menyo, amakamba, n'ibikoresho byinshi byo kurinda amenyo muri rusange biratekanye.

Amateka yawe bwite cyangwa ay'umuryango w'indwara zifata ubwonko (seizures) yongera ibyago byawe, nubwo indwara zifata ubwonko mu gihe cya TMS zikiri gake cyane (ku bantu batarenze 0.1%). Muganga wawe azasuzuma neza ibi byago kandi ashobora no gushimangira imiti hamwe n'ingamba zikwiye.

Imiti imwe na imwe ishobora kugabanya urwego rwawe rwo gufatwa n'indwara zifata ubwonko kandi bikongera ibyago. Ibi birimo imiti imwe na imwe ikoreshwa mu kuvura depression, imiti ikoreshwa mu kuvura indwara zo mu mutwe, n'imiti ikoreshwa mu kuvura ADHD. Muganga wawe azareba imiti yose ukoresha kandi ashobora kuyihindura niba bibaye ngombwa.

Gusama muri rusange bifatwa nk'ikintu kitagomba gukoreshwa na TMS, atari uko bizwi ko byangiza, ahubwo ni uko nta bushakashatsi buhagije bwo kwemeza umutekano. Niba utwite cyangwa ufite gahunda yo gutwita, ganira n'umuganga wawe ku miti isimbura.

Ibyo bigendanye n'imyaka na byo bishobora kugira uruhare mu kuvurwa kwawe. Nubwo TMS yemerewe abantu bakuru, abantu bakuze bashobora kugira ibisubizo bitandukanye cyangwa kwihanganira. Abarwayi bakuze cyane bashobora gukenera uburyo bwo kuvura buhinduka cyangwa gukurikiranwa neza.

Ni izihe ngaruka zishobora guterwa na Transcranial Magnetic Stimulation?

Ingaruka zikunze kugaragara za TMS ni nto kandi z'agateganyo, akenshi zikemuka nyuma y'amasaha make yo kuvurwa. Kubabara umutwe bibaho ku bantu bagera kuri 40%, cyane cyane mu cyumweru cya mbere cyo kuvurwa, ariko ibi akenshi bigabanuka uko umuntu amenyera ubuvuzi.

Kutamererwa neza cyangwa kubabara ku mutwe ahantu havurirwa bigira ingaruka ku barwayi benshi mu ntangiriro. Ibi byumvikana nk'ububabare cyangwa kubabara ahantu hashyizweho uruziga rwa magneti, bisa nk'uko umutwe wawe wumva nyuma yo kwambara umukufi ubyemye. Kutamererwa neza akenshi bigabanuka cyane nyuma y'amavuriro make ya mbere.

Abantu bamwe bagira imitsi yo mu maso ikorora cyangwa ikiruka mu gihe cyo kuvurwa, cyane cyane niba uruziga rwa magneti rutera imitsi yo mu maso. Nubwo ibi bishobora gutangaza, ntibiteje akaga kandi akenshi bikemuka vuba iyo umwanya w'uruziga uhindutse.

Impinduka zo kumva zirashoboka kubera amajwi akomeye yo gukanda mu gihe cyo kuvurwa, nubwo kwangirika gukomeye kumva gukunda kubaho cyane iyo hakoreshwa uburyo bwo kwirinda neza. Abarwayi bamwe bavuga ko bagira urusaku rw'agateganyo mu matwi yabo (tinnitus) nyuma y'amavuriro.

Ingaruka zikomeye cyane ntizisanzwe ariko ni ngombwa kuzisobanukirwa. Ibikomere bibaho ku bantu batarenze 1 kuri 1,000, kandi iyo bibaye, akenshi biba bigufi kandi bikemuka nta ngaruka zirambye. Itsinda ryawe rivura ryatojwe guhangana n'iki kibazo giteye ubwoba.

Mu bihe bidasanzwe cyane, abarwayi bamwe bagira impinduka z'amarangamutima zisa nkaho zidasobanutse, nk'uko kwiyongera kw'umujinya cyangwa guhungabana. Izi ngaruka akenshi ziba z'agateganyo, ariko ni ngombwa kumenyesha umuganga wawe ibijyanye n'impinduka z'amarangamutima.

Ingaruka zirambye ziracyigwaho, ariko ubushakashatsi buriho bwerekana ko TMS ntigira ingaruka zirambye ku bwonko cyangwa impinduka zikomeye ku myumvire. Ingaruka nyinshi zigaragara zikira burundu mu minsi cyangwa mu byumweru nyuma yo kurangiza kuvurwa.

Kuki nkwiriye kubona umuganga ku bijyanye na Transcranial Magnetic Stimulation?

Ugomba guhita uvugana n'umuganga wawe niba ubonye ibimenyetso bisa n'ibyo gufatwa n'urugimbu mu gihe cyangwa nyuma yo kuvurwa na TMS. Ibi bikubiyemo guhinda umushyitsi bitagira uko bigarurwa, gutakaza ubwenge, urujijo, cyangwa igihe icyo aricyo cyose utamenya ibikukuzengurutse.

Umuvuduko mwinshi, impinduka zidasanzwe mu myitwarire, impinduka zikomeye mu myumvire cyangwa ibitekerezo, kwigunga cyane, cyangwa ibitekerezo byo kwiyahura, bigomba kuvurwa ako kanya. Niba ufite ibyo bibazo, vugana n'abaganga bawe.

Umutwe ukabije udasubizwa n'imiti igabanya ububabare cyangwa umutwe ukomeza kwiyongera uko igihe kigenda gihita, ugomba gupimwa. Nubwo umutwe woroshye usanzwe, ububabare buhoraho cyangwa bukomeye bushobora kugaragaza ko hakenewe guhindura imiti yawe.

Ibibazo byo kumva, harimo no kuringa cyane mu matwi yawe, kumva bitumvikana neza, cyangwa gutakaza kumva, bigomba gutangazwa vuba. Muganga wawe ashobora gukenera guhindura imiti yawe cyangwa gutanga uburyo bwo kurinda kumva.

Niba utabonye impinduka nyuma y'amasomo 15-20, biganire n'ikipe ivura. Bashobora gukenera guhindura imiti, kongeraho izindi terapiya, cyangwa gutekereza ku bundi buryo.

Vugana na muganga wawe niba ugaragaje ibimenyetso byo kwandura ahantu havurirwa, nk'ubutukura budasanzwe, kubyimba, cyangwa gushyira amazi. Nubwo bidakunze kubaho, irari ryose ry'uruhu rihoraho rigomba gupimwa.

Ibibazo bikunze kubazwa kuri Transcranial Magnetic Stimulation

Q.1 Ese Transcranial Magnetic Stimulation ni nziza ku guhangayika?

TMS ishobora kugira akamaro ku bwoko bumwe bw'indwara zo guhangayika, cyane cyane iyo zigaragaye hamwe na depression. Abarwayi benshi babona impinduka nziza mu bimenyetso byabo byo guhangayika mugihe bavurwa depression, kuko uturere tw'ubwonko twitabira kugenzura imyumvire na two tugira ingaruka ku guhangayika.

Ubushakashatsi bwibanda cyane ku ndwara zo guhangayika buragenda bwiyongera, hamwe n'ibisubizo byiza ku ndwara rusange yo guhangayika no guhangayika mu mibanire. Ariko, TMS ntirashyirwaho na FDA byumwihariko ku ndwara zo guhangayika, bityo byafatwa nk'ikoreshwa hanze y'icyemezo.

Muganga wawe azasuzuma niba guhangayika kwawe gushobora kungukirwa na TMS hashingiwe ku bimenyetso byawe byihariye n'amateka y'imiti. Niba utarasubizwa neza n'imiti isanzwe yo guhangayika, TMS irashobora kuba ikwiye kuganirwaho nk'uburyo.

Q.2 Ese TMS itera ibibazo byo kwibuka?

TMS ntisanzwe itera ibibazo byo kwibuka kandi ishobora no kunoza imikorere y'ubwenge kuri bamwe barwayi. Bitandukanye na electroconvulsive therapy (ECT), ishobora gutera ibibazo byo kwibuka by'igihe gito, TMS irashyirwa mu ntego cyane kandi iroroshye.

Abarwayi benshi bavuga ko hariho impinduka nziza mu kwibanda, kwitondera, no gusobanukirwa neza mu mutwe uko ibimenyetso byabo bya depression bigenda birushaho. Ibi birashoboka ko bigaragaza imikorere y'ubwonko yarushijeho kunozwa aho kugira ingaruka zigororotse ku ngingo z'urwibutso.

Niba ufite impungenge ku mpinduka zo kwibuka mugihe uvurwa, andika buri munsi imikorere yawe y'ubwenge kandi uganire ku mpungenge zose n'ikipe ivura. Bashobora gufasha kumenya niba impinduka zifitanye isano na TMS cyangwa indwara yawe yihariye.

Q.3 Ese ibisubizo bya TMS bimara igihe kingana iki?

Ibisubizo bya TMS birashobora kumara hagati y'amezi atandatu n'umwaka umwe, hamwe n'abarwayi benshi bagumana impinduka zikomeye mu gihe kirekire. Igihe cy'inyungu gitandukanye cyane hagati y'abantu kandi giterwa n'ibintu nk'indwara yawe yihariye n'ubuzima bwawe muri rusange.

Abantu bamwe bungukirwa n'amasomo ya TMS yo gukomeza buri mezi make kugirango bagumane impinduka zabo. Ubu buvuzi bwo gukomeza busanzwe bukoreshwa gake kurusha amasomo yambere kandi bushobora gufasha kwirinda gusubira inyuma kw'ibimenyetso.

Niba ibimenyetso byawe bigarutse nyuma yo kuvurwa neza na TMS, akenshi urashobora gusubiramo amasomo y'imiti hamwe n'ubushobozi busa. Abarwayi benshi basanga ko amasomo akurikira ya TMS akora neza cyangwa kurusha imiti yabo yambere.

Q.4 Ese TMS irishyurwa n'ubwishingizi?

Ubwishingizi bwinshi bukomeye, harimo na Medicare, butanga TMS yo kuvura depression irwanya imiti iyo ibisabwa byihariye byujujwe.

Ubusanzwe ugomba kuba waragerageje kandi ukananirwa nibura imiti ibiri itandukanye yo kuvura umubabaro mbere yo kwemererwa kwishyurirwa.

Ibiro bya muganga wawe mubisanzwe bizafasha kubona uburenganzira mbere yo kwishyura kandi bishobora gutanga inyandiko y'amateka yawe yo kuvurwa. Uburyo bwo kwemererwa burashobora gufata ibyumweru byinshi, bityo ni ngombwa gutangira ibi hakiri kare mugutegura kuvurwa kwawe.

Kubijyanye nibindi bibazo bitari umubabaro, ubwishingizi butandukanye cyane. Gahunda zimwe na zimwe zirashobora kwishyura TMS kubera OCD cyangwa izindi ngingo zemewe, mugihe izindi zitabikora. Buri gihe genzura numwishingizi wawe kubijyanye nibisobanuro byihariye byo kwishyurwa.

Q.5 Nshobora gutwara imodoka nyuma yo kuvurwa na TMS?

Yego, urashobora gutwara imodoka ako kanya nyuma y'amasomo ya TMS. Bitandukanye nizindi mvura yo gushishikariza ubwonko, TMS ntigira uruhare mubitekerezo byawe, imikoranire, cyangwa imanza, bityo urashobora gusubira mumikorere isanzwe ako kanya.

Abantu benshi bitwara imodoka bajya no ku nama za TMS nta kibazo. Ubuvuzi ntibuteza umunaniro cyangwa urujijo, bikakwemerera gukomeza gahunda yawe ya buri munsi.

Ariko, niba ubonye umutwe nyuma yo kuvurwa, urashobora gutegereza kugeza igihe kigabanutse mbere yo gutwara. Abantu bamwe bakunda ko undi muntu abajyana murugo nyuma yamasomo yabo ya mbere kugeza bamenye uko bitwara mugihe bavurwa.