老年睡眠障碍的重复经颅磁刺激精准干预专家共识OA

In recent years,repetitive transcranial magnetic stimulation(rTMS)has garnered significant attention as a therapeutic approach for sleep disorders in the elderly.However,the prevailing rTMS protocols are predominantly developed based on normative neurophysiological data derived from young adults and fail to incorporate individualized parameters tailored to the brain characteristics of the elderly.To address this gap,the consensus development group synthesized the latest evidence from 2010 to 2025 and established a standardized rTMS protocol specifically for elderly patients with sleep disorders.Adhering to the Appraisal of Guidelines for Research and Evaluation II(AGREE II)framework,systematically screened randomized controlled trials(RCTs)and systematic reviews regarding rTMS in the treatment of sleep disorders across various conditions.Meanwhile,the Grading of Recommendations Assessment,Development and Evaluation(GRADE)system was employed to rigorously grade the quality of evidence and the strength of recommendations.This consensus guideline delineates precise rTMS protocols for the management of sleep disorders in the elderly,highlights the adjustment of stimulation intensity according to scalp-cortex distance recommends either MRI-guided neuronavigation or the Beam F3/F4 heuristic approach for accurate target localization,thereby providing precise rTMS intervention protocol for sleep disorders in the elderly,aiming to enhance clinical efficacy while ensuring treatment safety.