摘要
目的探讨重复经颅磁刺激（rTMS）治疗对单相抑郁症患者认知功能的影响。方法将69例单相抑郁症患者入院后即随机分为2组（真刺激组35例，伪刺激组34例），真刺激组在抗抑郁药盐酸文拉法辛缓释片治疗的基础上给予左侧背外侧前额叶10Hz、80％运动阈值刺激强度、每周5次的rTMS治疗，伪刺激组为相应部位的伪刺激。rTMS治疗前及治疗6周末，分别行P300、重复成套神经心理测试（RBANS）、威斯康星卡片分类测验（WCST）及24项汉密尔顿抑郁量表（HAMD-24）评定。结果rTMS治疗6周末，真刺激组WCST总正确数[（33．23±10．29）个]等项改善优于伪刺激组[（27．09±9．82）个]，存在组别×时间交互作用（F=4．862～17，758，P=0．031～0．000）；真刺激组RBANS总分[（88．83±16．48）分]等项改善优于伪刺激组[（78．85±13．51）分]，存在组别X时间交互作用（F=8．425～20．801，P=0．005～0．000）；真刺激组P3波幅[（8．27±2．97）μv]改善优于伪刺激组[（7．37±2．66）μv]，存在组别×时间交互作用（F=5．838，P=0．018）；真刺激组HAMD．24[（4．7±2．4）分]改善优于伪刺激组[（11．2±5．1）分]，存在组别×时间交互作用（F=29．537，P=0．000）。结论rTMS治疗可有效改善单相抑郁症患者的认知功能及抑郁情绪。
Objective To investigate the effects of left dorsolateral prefrontal cortex with 10HZ , 80% motor threshold repetitive transcranial magnetic stimulation （rTMS） on the cognitive function in unipolar depression. Method Sixty-nine patients with unipolar depressiou were randomly assigned to either the real rTMS group or the sham rTMS treatment（ the control group）, all patients were given extended releasing venlafaxine . the cognitive function was evaluated using P300 and Repeatable battery for the assessment of neuropsyehological status （ RBANS-immediate memory, visuospatial, language, attention, delayed memory, total score） , Wisconsin card sorting test（ WCST-Right responses, Completed categories, Total errors , Preservative errors, Nonpreservative errors）. The depression severity was assessed with the 24-item Hamilton Rating Scale for Depression（HAMD-24）. All of tests were examined before and after six weeks with thirty times rTMS. Results At the end of six weeks treatments,regarding the WCST ,real rTMS group showed better improvement in the right responses than control group（ 33.23 ± 10.29 vs 27.09 ± 9.82, F= 16.116 , P = 0. 000）, besides right responses, real rTMS group had better performance in the rest items than control group（F = 4. 862 -17. 758, P = 0, 031 -0. 000） ;concerning the RBANS, real rTMS group was significantly superior to control group in total score （ （ 88.83 ± 16.48） vs （78.85 ± 13.51 ）, F = 8. 425, P = 0. 005 ）, besides total score , the real rTMS group had better performance in some rest factors than control group （F= 10. 088 -20. 801, P = 0. 002 - 0. 000 ）;real rTMS group showed better improvement in the amplitude of P3 than control group（ （8.27 ±2.97） μV vs （7.37 ±2.66） μV, F=5. 838 , P=0. 018） ;real rTMS group demonstrated better improvement in HAMD-24 than control group （ （4.7± 2.4） vs （ 11.2 ± 5. 1 ）, F = 29. 537, P = 0. 000）. Conclusion rTMS can significantly improve cognitive function and depressive symptoms with unipolar depression.
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2011年第3期250-252,共3页
Chinese Journal of Behavioral Medicine and Brain Science
关键词
单相抑郁症
认知功能
重复经颅磁刺激
Unipolar depression
Cognitive function
Repetitive transcranial magnetic stimulation
