Abstract:
We report a case of a new-onset, persistent tremor that developed during a clinical trial (NCT02927236) of intermittent theta burst stimulation [iTBS, a form of repetitive magnetic transcranial magnetic stimulation (rTMS)] for cocaine use disorder. Although the participant exhibited an exceptionally strong clinical response, subsequent unblinding revealed that they received sham iTBS. This case highlights the potential for strong functional neurological placebo responses in rTMS trials, and functional disorders might be a marker of a placebo response. Additionally, we note the possibility that the weak e-fields produced by some sham rTMS systems may induce clinically relevant effects.
摘要:
我们报告了一个新的病例,在间歇性theta爆发刺激的临床试验(NCT02927236)期间发生的持续性震颤[iTBS,一种用于可卡因使用障碍的重复磁经颅磁刺激(rTMS)]。尽管参与者表现出异常强烈的临床反应,随后的脱盲显示他们接受了假iTBS.这个案例强调了rTMS试验中强大的功能性神经安慰剂反应的潜力,和功能障碍可能是安慰剂反应的标志。此外,我们注意到一些假rTMS系统产生的弱电场可能会引起临床相关效应。