摘要
目的:探讨右侧前额叶皮质重复经颅磁刺激(r TMS)治疗双相障碍躁狂发作的疗效和安全性。方法:33例符合《美国精神障碍诊断与统计手册第4版》双相障碍躁狂发作诊断标准的患者随机分为研究组17例和对照组16例,两组均给予丙戊酸钠缓释片;在此基础上,研究组给予20 Hz r TMS真刺激,对照组给予伪刺激,每天1次,共10次。采用躁狂量表(BRMS)、治疗中出现的症状量表(TESS)于治疗前和治疗5、10 d分别评估临床疗效及不良反应。结果:治疗前及治疗5 d,BRMS评分两组差异无统计学意义(t=1.439,t=-0.204;P>0.05);治疗10 d,研究组BRMS评分明显低于对照组,差异有统计学意义(t=-4.558,P=0.000)。未观察到明显不良反应。结论:心境稳定剂合并右前额皮质r TMS治疗双相障碍躁狂发作患者有效、安全。
Objective：To examine the effectiveness and safety of repetitive transcranial magnetic stimu-lation（ rTMS）treatment on the right prefrontal cortex for patients in the manic episode of bipolar affective disor-der. Method：Thirty-three patients who met the criteria for bipolar disorder,manic episode in the diagnostic and statistical manual of mental disorders fourth edition were recruited. 17 of them were randomly chosen into the research group,and 16 into the control group. The dosage of sodium valproate for both groups was kept un-changed. Each subject in the research group received rTMS at 20 Hz,while the subjects in the control group re-ceived sham stimulation. Stimulation was once per day for 10 days. Before treatment,5 days into treatment,and 10 days into treatment,clinical effect were measured with the Bech-Rafaelsen mania rating scale（ BRMS）,and side effects were valuated with the treatment emergent symptom scale（ TESS）. Resuits：Before treatment and 5 days into treatment,there was no statistically significant difference in BRMS scores between the two groups （t=1. 439,t= -0. 204;P〉0. 05）. 10 days into treatment,the BRMS scores of the research group were signifi-cantly lower than those of the control group（t= -4. 558,P=0. 000）. No obvious side effects were noticed. Conciusion：It is effective and safe to treat patients in the manic episode of bipolar disorder using rTMS on the right prefrontal cortex,combined with mood stabilizer.
出处
《临床精神医学杂志》
2015年第3期185-187,共3页
Journal of Clinical Psychiatry
基金
国家精神科临床重点专科(201201005)
关键词
重复经颅磁刺激
双相障碍躁狂发作
丙戊酸
repetitive transcranial magnetic stimulation
manic episodes of bipolar disorder
valpro-ic acid
