Yini i-Transcranial Magnetic Stimulation? Inhloso, Inqubo & Nemiphumela

I-Transcranial Magnetic Stimulation (TMS) iyindlela yokwelapha ubuchopho engahlaseli esebenzisa amandla kazibuthe ukuze isebenzise izindawo ezithile zobuchopho bakho. Cabanga ngayo njengendlela enobumnene yoku "vusa" izindawo zobuchopho ezingasebenzi kahle njengoba kufanele, ikakhulukazi ezimweni ezinjengokucindezeleka lapho imijikelezo ethile yobuchopho iba ngaphansi kokusebenza.

Lokhu kwelashwa okuvunywe yi-FDA kube kusiza abantu ukuthi bathole impumuzo ezimweni ezahlukene zempilo yengqondo kusukela ngo-2008. Le nqubo yenziwa ehhovisi likadokotela ngenkathi uvukile futhi uqaphile, okwenza kube enye indlela enobumnene kakhulu kunokwelashwa okujulile.

Yini i-Transcranial Magnetic Stimulation?

I-TMS isebenza ngokubeka ikhoyili kazibuthe ebunzini lakho ukuze inikeze ama-pulse kazibuthe aqondiswe ezindaweni ezithile zobuchopho. Lawa ma-pulse afana ngamandla nalawo asetshenziswa emishinini ye-MRI, kodwa aqondiswe ukukhuthaza ama-neuron ezindaweni ezilawula imizwa, ukucabanga, nokuziphatha.

Amandla kazibuthe adlula ngobuhlungu ngobende lakho futhi akhe amandla kagesi amancane emathisheni akho obuchopho. Lawa mandla asiza "ukulungisa kabusha" izindlela ze-neural ezingase ziphazamiseke ngenxa yokucindezeleka, ukukhathazeka, noma ezinye izimo.

Kunezinhlobo ezimbili eziyinhloko ongahlangana nazo. I-Repetitive TMS (rTMS) inikeza ama-pulse avamile ngendlela enesigqi, kuyilapho i-theta burst stimulation inikeza ama-burst amafushane, aqine kakhulu. Udokotela wakho uzokhetha indlela ekufanele kakhulu isimo sakho esithile.

Kungani kwenziwa i-Transcranial Magnetic Stimulation?

I-TMS isetshenziswa ikakhulukazi lapho ukwelashwa kwendabuko kungazange kunikeze impumuzo eyanele ezimpawini zakho. Ivame kakhulu ukunqunywa ekwelapheni ukucindezeleka okumelana nokwelashwa, okusho ukuthi uzamile okungenani imithi emibili ehlukene yokulwa nokucindezeleka ngaphandle kwempumelelo.

Ngaphandle kokucindezeleka, i-TMS ingasiza ngezinye izimo eziningi ezithinta izinga lempilo yakho. Udokotela wakho angase ayincomise ngokuphazamiseka okucindezelayo (OCD), ikakhulukazi lapho imicabango engahleliwe nokuziphatha okucindezelayo kuqhubeka naphezu kokunye ukwelashwa.

Ukwelashwa futhi kusetshenziselwa ukuvimbela i-migraine, ikakhulukazi kubantu abahlangabezana nekhanda elivame ukukhubaza. Ezinye iziguli zithola i-TMS ilusizo ekuphazamisekeni kokukhathazeka, ukuphazamiseka kokucindezeleka ngemva kwengozi (PTSD), ngisho nezimo ezithile zobuhlungu.

Ezimweni ezingavamile, i-TMS ingase icatshangelwe ngezimo ezinjengokuphazamiseka kwe-bipolar, i-schizophrenia, noma ukuphazamiseka kokudla, nakuba lezi zicelo zisacwaningwa. Umhlinzeki wakho wokunakekelwa kwezempilo uzohlola ngokucophelela ukuthi i-TMS ifanele yini isimo sakho esithile.

Yini inqubo ye-Transcranial Magnetic Stimulation?

Iseshini yakho yokuqala ye-TMS izohlala isikhathi eside kunokujwayelekile ngoba udokotela wakho udinga ukwenza imephu yobuchopho bakho futhi athole amandla afanele okukhuthaza. Uzohlala esihlalweni esinethezekile ngenkathi uchwepheshe ebeka ikhoyili kazibuthe ekhanda lakho, ngokuvamile ngaphezu kwe-cortex yangaphambili yangakwesobunxele.

Inqubo yokwenza imephu ihlanganisa ukuthola

Ukwelashwa kwenziwa ngaphandle kokulaliswa esibhedlela, ngakho-ke ungazishayela wena uye futhi ubuye ekuqokweni. Ngokungafani nokunye ukwelashwa kokukhuthaza ubuchopho, i-TMS ayidingi i-anesthesia noma i-sedation, okukuvumela ukuthi uqhubeke nemisebenzi yakho yansuku zonke.

Ungalungiselela kanjani i-Transcranial Magnetic Stimulation yakho?

Ukulungiselela i-TMS kulula kakhulu, kodwa kunezinyathelo ezibalulekile zokuqinisekisa ukuphepha kwakho nokusebenza kokwelashwa. Udokotela wakho uzoqala ngokwenza ukuhlolwa okujulile kwezokwelapha, okuhlanganisa imibuzo mayelana nanoma yiziphi izinto zensimbi ezifakelwe emzimbeni, izinto zokwelapha, noma imithi oyithathayo.

Uzodinga ukususa noma yiziphi izinto zensimbi ekhanda lakho nasentanyeni ngaphambi kweseshini ngayinye. Lokhu kuhlanganisa ubucwebe, izipikili zezinwele, izinsiza zokuzwa, kanye nomsebenzi wamazinyo osuswayo. Lezi zinto zingaphazamisa inkambu kazibuthe noma zishise ngesikhathi sokwelashwa.

Yazisa ithimba lakho lezempilo ngemithi oyithathayo, ikakhulukazi lezo ezinciphisa umkhawulo wakho wokuthuthumela. Ngenkathi ukuthuthumela kungavamile kakhulu nge-TMS, imithi ethile ingakhuphula kancane le ngozi. Udokotela wakho angase alungise imithi yakho okwesikhashana uma kudingeka.

Ngezinsuku zokwelashwa, yidla ngokujwayelekile futhi uhlale unamanzi. Ungase ufune ukuletha ama-headphone noma ama-earplug, njengoba imisindo yokuchofoza ingaba phezulu, nakuba imitholampilo eminingi inikeza ukuvikelwa kwezindlebe. Abanye abantu bakuthola kuwusizo ukuletha incwadi noma umculo ukusiza ukudlulisa isikhathi ngesikhathi samaseshini.

Uma unokukhathazeka mayelana ne-claustrophobia noma ukukhathazeka mayelana nenqubo, xoxa ngalokhu nethimba lakho lokwelapha ngaphambi kwesikhathi. Bangakusiza ukuthi uzizwe ukhululekile futhi bangase baphakamise izindlela zokuphumula.

Ungawafunda kanjani imiphumela yakho ye-Transcranial Magnetic Stimulation?

Imiphumela ye-TMS ayilinganiswa ngezivivinyo zokuhlola zendabuko noma izifundo zokucabanga. Esikhundleni salokho, inqubekela phambili yakho ihlolwa ngezilinganiso zokulinganisa izimpawu, imibuzo yomoya, kanye nokuhlolwa okuvamile nomhlinzeki wakho wezempilo mayelana nendlela ozizwa ngayo.

Unga qala ukuqaphela ukuthuthuka kwemizwa yakho, amazinga amandla, noma ezinye izimpawu ngemva kwamasonto amabili kuya kwamathathu okwelashwa. Abanye abantu bathola izinguquko ezinensayo, kanti abanye baqaphela ukuthuthuka okungazelelwe. Zombili lezi zindlela zivamile ngokuphelele futhi azibikezeli umphumela wakho wokugcina.

Udokotela wakho cishe uzosebenzisa izikali ezijwayelekile zokucindezeleka noma ukukhathazeka ukuze alandelele intuthuko yakho ngendlela enengqondo. Le mibuzo isiza ukukala izinguquko ekulaleni, isifiso sokudla, ukugxila, kanye nemizwa yonke ongase ungayiqapheli usuku nosuku.

Ukusabela ku-TMS kuvame ukuchazwa njengokuthuthuka okungama-50% noma ngaphezulu ekuqineni kwezimpawu, kuyilapho ukuxolelwa kusho ukuthi izimpawu zakho zehlele emazingeni amancane. Cishe ama-60% abantu bathola ukuthuthuka okukhulu, futhi cishe ingxenye eyodwa kwezintathu ifinyelela ekuxolelweni.

Khumbula ukuthi izinzuzo zingase ziqhubeke nokuthuthuka amasonto amaningana ngemva kokuphela kwenkambo yakho yokwelashwa. Abanye abantu baqaphela imiphumela yabo engcono kakhulu ngemva kwenyanga eyodwa kuya kwemithathu ngemva kokwelashwa, ngakho ukubekezela kubalulekile ngalesi sikhathi.

Ungawathuthukisa kanjani imiphumela yakho ye-Transcranial Magnetic Stimulation?

Ukwandisa izinzuzo zakho ze-TMS kuhilela ukugcina ukuqina ngeshejuli yakho yokwelashwa nokusekela impilo yakho yonke yengqondo. Ukweqa izikhathi kunganciphisa ukusebenza kokwelashwa, ngakho zama ukuya kuwo wonke ama-aphoyintimenti ahleliwe ngisho noma ungezwa ukuthuthuka okusheshayo.

Qhubeka nokuthatha noma yimiphi imithi echazwe ngaphandle uma udokotela wakho ekweluleka ngenye indlela. I-TMS ivame ukusebenza kahle uma ihlanganiswe nama-antidepressants noma eminye imithi osuvele uyithatha. Ungayeki noma ushintshe imithi ngaphandle kokuxoxa ngayo nomhlinzeki wakho wezempilo kuqala.

Ukusekela ukwelashwa kwakho ngokukhetha indlela yokuphila enempilo kungathuthukisa imiphumela yakho. Ukuzivocavoca njalo, ukulala okwanele, nokudla okunempilo konke kusekela impilo yobuchopho futhi kungasiza i-TMS isebenze ngempumelelo. Ngisho nemisebenzi elula efana nokuhamba ingaba usizo.

Cabanga ngokungeza i-psychotherapy ohlelweni lwakho lokwelashwa uma ungasebenzi nodokotela wezengqondo. Abantu abaningi bathola ukuthi i-TMS ibenza bamukeleke kakhulu ekwelashweni, futhi le nhlanganisela ivame ukukhiqiza imiphumela engcono kunanoma yikuphi ukwelashwa okukodwa.

Hlala uxhumekile ohlelweni lwakho lokusekela ngesikhathi sokwelashwa. Yazisa umndeni nabangane ngohambo lwakho lwe-TMS ukuze bakwazi ukukunikeza isikhuthazo futhi bakusize uqaphele izinguquko ezinhle ongase uziphuthele.

Ziyini izici eziyingozi zezinkinga ze-TMS?

Abantu abaningi bayayibekezelela kahle kakhulu i-TMS, kodwa izici ezithile zingakhuphula ingozi yakho yemiphumela emibi noma zikwenze ungafaneleki ukwelashwa. Ukuba nezinto zensimbi eziqhumayo ekhanda lakho noma eduze kwekhanda lakho yisici esiyingozi esibaluleke kakhulu, njengoba lezi zingashisa noma zinyakaze ngesikhathi sokwelashwa.

Izinto zensimbi ezithile ezenza i-TMS ingaphephile zihlanganisa izitshalo ze-cochlear, izikhuthazi zobuchopho obujulile, izikhuthazi zemizwa ye-vagus, nezinhlobo ezithile zama-aneurysm clips. Kodwa-ke, ukugcwaliswa kwamazinyo, imiqhele, kanye nempahla eningi ye-orthodontic ngokuvamile kuphephile.

Umlando womuntu siqu noma womndeni wokuquleka ukwandisa ingozi yakho, nakuba ukuquleka ngesikhathi se-TMS kuhlala kungavamile kakhulu (ngaphansi kuka-0.1% weziguli). Udokotela wakho uzoyihlola ngokucophelela le ngozi futhi angase ancome ukwelashwa ngezinyathelo zokuphepha ezifanele.

Imithi ethile inganciphisa umkhawulo wakho wokuquleka futhi ingase ikhuphule ingozi. Lokhu kuhlanganisa ezinye izidambisi zokucindezeleka, ama-antipsychotics, kanye nemithi esetshenziselwa i-ADHD. Udokotela wakho uzobuyekeza yonke imithi yakho futhi angayilungisa uma kudingeka.

Ukukhulelwa ngokuvamile kuthathwa njenge-contraindication ye-TMS, hhayi ngoba kwaziwa ukuthi kuyingozi, kodwa ngoba akukho ucwaningo olwanele lokuqinisekisa ukuphepha. Uma ukhulelwe noma uhlela ukukhulelwa, xoxa ngezindlela zokwelapha ezingezinye nodokotela wakho.

Izici ezihlobene nobudala

Izici ezihlobene nobudala nazo zingase zithinte ukwelashwa kwakho. Ngenkathi i-TMS ivunyelwe kubantu abadala, abadala asebekhulile bangase babe nokusabela okuhlukile noma ukubekezelela. Iziguli ezindala kakhulu zingase zidinge izindlela zokwelapha eziguquliwe noma ukuqapha okucophelelayo.

Ziyini izinkinga ezingase zibe khona ze-Transcranial Magnetic Stimulation?

Imiphumela emibi ejwayelekile ye-TMS imnene futhi yesikhashana, ngokuvamile ixazululwa kungakapheli amahora ambalwa ngemva kokwelashwa. Ikhanda liba khona cishe kuma-40% eziguli, ikakhulukazi ngesonto lokuqala lokwelashwa, kodwa lokhu kuvame ukuba mancane njengoba ujwayela ukwelashwa.

Ukuphatheka kabi kwesikhumba sekhanda noma ubuhlungu endaweni yokwelashwa kuthinta iziguli eziningi ekuqaleni. Lokhu kuzizwa njengobumnene noma ubuhlungu lapho kwakubekwe khona ikhoyili kazibuthe, kufana nendlela isikhumba sekhanda lakho esingase sizizwe ngayo ngemva kokugqoka isigqoko esiqinile. Ukuphatheka kabi ngokuvamile kuncipha kakhulu ngemva kwemihlangano embalwa yokuqala.

Abanye abantu bazwa ukuthuthumela kwemisipha yobuso noma ama-spasms ngesikhathi sokwelashwa, ikakhulukazi uma ikhoyili kazibuthe ivuselela imizwa yobuso eseduze. Nakuba lokhu kungase kumangaze, akuyona ingozi futhi ngokuvamile ixazululwa ngokushesha uma isikhundla sekhoyili silungiswa.

Ushintsho lokuzwa lungenzeka ngenxa yemisindo echofoza kakhulu ngesikhathi sokwelashwa, nakuba ukulimala okukhulu kokuzwa kungavamile kakhulu uma kusetshenziswa ukuvikelwa kwezindlebe okufanele. Ezinye iziguli zibika ukukhala okwesikhashana ezindlebeni zazo (i-tinnitus) ngemva kwemihlangano.

Izinkinga ezingathi sína zivamile kakhulu kodwa kubalulekile ukuziqonda. Ukuhlaselwa kwenzeka kwiziguli ezingaphansi kwe-1 kwabangu-1,000, futhi uma kwenzeka, ngokuvamile ziba mfushane futhi zixazululwe ngaphandle kwemiphumela ehlala njalo. Ithimba lakho lokwelapha liqeqeshwe ukubhekana nalezi zimo ezingavamile eziphuthumayo.

Ezimweni ezingavamile kakhulu, ezinye iziguli ziba nokushintsha kwemizwa okubonakala kungqubuzana, njengokwanda kokukhathazeka noma ukucasuka. Le miphumela ivame ukuba yesikhashana, kodwa kubalulekile ukubika noma yiziphi izinguquko zemizwa ezikhathazayo kumhlinzeki wakho wezempilo ngokushesha.

Imiphumela yesikhathi eside isafundwa, kodwa ucwaningo lwamanje luphakamisa ukuthi i-TMS ayibangeli umonakalo wobuchopho ohlala njalo noma izinguquko ezinkulu zokuqonda. Imiphumela eminingi emibi iyanyamalala ngokuphelele ezinsukwini kuya emavikini ngemva kokuqeda ukwelashwa.

Kufanele ngibone nini udokotela mayelana ne-Transcranial Magnetic Stimulation?

Kufanele uthinte umhlinzeki wakho wezempilo ngokushesha uma uhlangabezana nanoma yimuphi umsebenzi ofana nokuhlaselwa ngesikhathi noma ngemva kokwelashwa kwe-TMS. Lokhu kuhlanganisa ukuthuthumela okungalawuleki, ukulahlekelwa ukwazi, ukudideka, noma yisiphi isigameko lapho ulahlekelwa ukuqwashisa ngendawo okuyo.

Ukushintsha kokuziphatha, imizwa emisha noma ehlukile, noma imicabango yokuzibulala kufanele kuthathwe njengento ebalulekile futhi idinge ukunakwa ngokushesha. Uma uhlangabezana nanoma yiziphi izinguquko ezinjalo, xhumana nethimba lakho lezokwelapha ngokushesha.

Ikhanda elibuhlungu elingaphenduli emithini yokwelapha ubuhlungu etholakala ngaphandle kwemvume kadokotela noma amakhanda abuhlungu aqhubeka eba buhlungu ngokuhamba kwesikhathi kufanele ahlolwe. Nakuba amakhanda abuhlungu alula ejwayelekile, ubuhlungu obuqhubekayo noma obukhulu bungase bubonise isidingo sokulungisa izindlela zakho zokwelapha.

Izinkinga zokuzwa, okuhlanganisa ukukhala okukhulu ezindlebeni zakho, ukuzwa okufiphele, noma ukulahlekelwa ukuzwa, kufanele kubikwe ngokushesha. Udokotela wakho angase adinge ukushintsha ukwelashwa kwakho noma anikeze ukuvikelwa okwengeziwe kokuzwa.

Uma ungaboni ngcono ngemva kwemihlangano engu-15-20, xoxa lokhu nethimba lakho lokwelapha. Bangase badinge ukulungisa izindlela zokwelapha, bangeze ezinye izindlela zokwelapha, noma bacabange ngezindlela ezingezinye.

Xhumana nodokotela wakho uma uqaphela noma yiziphi izimpawu zokutheleleka endaweni yokwelapha, njengobubomvu obungavamile, ukuvuvukala, noma ukukhipha. Nakuba kungavamile kakhulu, noma yikuphi ukucasuka kwesikhumba okuqhubekayo kufanele kuhlolwe.

Imibuzo evame ukubuzwa mayelana ne-Transcranial Magnetic Stimulation

Q.1 Ingabe i-Transcranial Magnetic Stimulation ilungele ukukhathazeka?

I-TMS ingasebenza ezinhlotsheni ezithile zokuphazamiseka kokukhathazeka, ikakhulukazi uma kwenzeka kanye nokucindezeleka. Iziguli eziningi zibona ngcono izimpawu zokukhathazeka ngesikhathi sokwelashwa kokucindezeleka, njengoba izindawo zobuchopho ezihilelekile ekulawuleni imizwa nazo zithinta ukukhathazeka.

Ucwaningo olugxile ngokuqondile ekuphazamisekeni kokukhathazeka luyakhula, ngemiphumela ethembisayo yokuphazamiseka kokukhathazeka okujwayelekile nokukhathazeka komphakathi. Nokho, i-TMS ayikavunywa yi-FDA ngokuqondile yokuphazamiseka kokukhathazeka, ngakho-ke kungathathwa njengokusebenzisa ngaphandle kwemvume.

Udokotela wakho uzohlola ukuthi ukukhathazeka kwakho kungazuza yini ku-TMS ngokusekelwe ezimpawini zakho ezithile kanye nomlando wokwelashwa. Uma ungazange uphendule kahle ekwelashweni okujwayelekile kokukhathazeka, i-TMS ingase ifanele ukuxoxwa njengenketho.

Q.2 Ingabe i-TMS ibangela izinkinga zenkumbulo?

I-TMS ngokuvamile ayibangeli izinkinga zenkumbulo futhi empeleni ingathuthukisa ukusebenza kwengqondo ezigulini ezithile. Ngokungafani nokwelashwa ngogesi (ECT), okungabangela izinkinga zenkumbulo zesikhashana, i-TMS iqondiswe kakhulu futhi inobungane.

Iziguli eziningi zibika ukuthuthuka ekugxileni, ukugxila, kanye nokucaca kwengqondo njengoba izimpawu zokucindezeleka zabo zithuthuka nge-TMS. Lokhu cishe kubonisa ukusebenza kobuchopho obuthuthukisiwe kunokuba nemiphumela eqondile ezikhungweni zenkumbulo.

Uma ukhathazekile ngezinguquko zenkumbulo ngesikhathi sokwelashwa, gcina iphephabhuku lansuku zonke lokusebenza kwakho kwengqondo futhi uxoxe nganoma yikuphi ukukhathazeka nethimba lakho lokwelapha. Bangakwazi ukusiza ukunquma ukuthi izinguquko zihlobene ne-TMS noma isimo sakho esiyisisekelo.

Q.3 Zingakanani izikhathi imiphumela ye-TMS ehlala ngayo?

Imiphumela ye-TMS ingahlala noma yikuphi kusukela ezinyangeni eziyisithupha kuya ngaphezu konyaka, neziguli eziningi zigcina ukuthuthuka okukhulu isikhathi eside. Ubude bezinzuzo buhlukahluka kakhulu phakathi kwabantu futhi kuncike ezintweni ezifana nesimo sakho esithile nempilo yonke.

Abanye abantu bayazuza emihlanganweni yokulungisa i-TMS njalo ezinyangeni ezimbalwa ukuze baqhubeke nokuthuthuka kwabo. Lokhu kwelashwa kokulungisa ngokuvamile akuvamile njengenkambo yokuqala futhi kungasiza ekuvikeleni ukuphindeka kwezimpawu.

Uma izimpawu zakho zibuyela ngemva kokwelashwa kwe-TMS okuphumelelayo, ngokuvamile ungaqhubeka nenkambo yokwelashwa ngempumelelo efanayo. Iziguli eziningi zithola ukuthi izifundo ze-TMS ezilandelayo zisebenza kahle noma zingcono kunokwelashwa kwazo kokuqala.

Q.4 Ingabe i-TMS ihlanganiswa ngumshuwalense?

Izinhlelo eziningi ezinkulu zomshuwalense, okuhlanganisa i-Medicare, zihlanganisa i-TMS yokucindezeleka okumelana nokwelashwa uma izindlela ezithile zihlangatshezwa.

Ngokuvamile udinga ukuzama futhi wehluleke okungenani imithi emibili ehlukene yokulwa nokucindezeleka ukuze ufanelekele ukuthola umshwalense.

Ihhovisi likadokotela wakho ngokuvamile lizosiza ngokugunyazwa kwangaphambi komshwalense futhi linganikeza imibhalo yomlando wakho wokwelashwa. Inqubo yokugunyazwa ingathatha amasonto amaningana, ngakho-ke kubalulekile ukuqala lokhu ekuqaleni kokuhlela kwakho ukwelashwa.

Ezimweni ezingezona ukucindezeleka, ukuthola umshwalense kuyahlukahluka kakhulu. Ezinye izinhlelo zingase zihlanganise i-TMS ye-OCD noma ezinye izimo ezigunyaziwe, kanti ezinye zingase zingabi njalo. Hlala uhlola nomhlinzeki wakho womshwalense ngemininingwane ethile yokuthola umshwalense.

Q.5 Ngingakwazi yini ukuqhuba imoto ngemva kokwelashwa kwe-TMS?

Yebo, ungaqhuba imoto ngokushesha ngemva kwemihlangano yokwelashwa kwe-TMS. Ngokungafani nokunye ukwelashwa kokuvuselela ubuchopho, i-TMS ayithinti ukuqwashisa kwakho, ukuxhumana, noma ukwahlulela, ngakho-ke ungaqala kabusha imisebenzi ejwayelekile ngokushesha.

Iziguli eziningi zizishayela ziye futhi zivela ekuqokweni kwe-TMS ngaphandle kwanoma yiziphi izinkinga. Ukwelashwa akubangeli ukuthuliswa noma ukudideka, okukuvumela ukuthi ugcine isimiso sakho sansuku zonke.

Noma kunjalo, uma uhlangabezana nekhanda ngemva kokwelashwa, ungase ufune ukulinda kuze kube yilapho liphela ngaphambi kokushayela. Ezinye iziguli zikhetha ukuba nomunye umuntu azishayele ekhaya ngemva kwemihlangano yazo yokuqala embalwa kuze kube yilapho zazi ukuthi zisabela kanjani ekwelashweni.