摘要
目的探讨功能磁共振(MRI)引导下的重复经颅磁刺激(rTMS)对抑郁症短期疗效和执行功能的影响。方法选取2019年11月至2020年3月收治的18~50岁的抑郁症患者59例,按随机数字表法随机分为MRI组、常规组和对照组,3组受试者均接受5-羟色胺再摄取抑制剂(SSRIs)类药物治疗,在此基础上,MRI引导的重复经颅磁刺激组采用静息态磁共振扫描进行个体化定位(MRI组,19例),常规重复经颅磁刺激组采用传统的“5 cm定位法”(常规组,20例),rTMS刺激频率为10 Hz,刺激强度为100%运动阈值,每次均刺激40个序列,每个刺激序列中刺激时间为5 s,间隔时间为20 s,每次共计接受1500个刺激脉冲。每周5次,连续2周共20次,对照组为仅单纯应用SSRIs类药物治疗(20例)。受试者于基线期、治疗2周末进行汉密尔顿抑郁量表17项版本(HAMD-17)、连线测试(TMT-A)和stroop色词测验(SCWT)的评估。结果3组受试者在性别比、年龄、文化程度、抑郁症家族史、首发年龄上均无统计学意义(P>0.05)。在治疗2周末,3组治疗总有效率分别是:MRI组:53.64%;常规组:20.00%;对照组:15.00%;MRI组的疗效要优于常规组和对照组(P=0.020)。MRI组、常规组和对照组在基线期的TMT-A、Stroop Word、Stroop Color、Stroop interference的评分比较差异均无统计学意义(P>0.05),重复测量方差分析发现,在TMT-A、Stroop Word、Stroop Color、Stroop interference评分上,时间效应均显著(P<0.05),时间和组间的交互作用也显著(P<0.05)。Bronfenni分析显示,在治疗2周末,MRI组和常规组的TMT-A评分明显高于对照组,差异有统计学意义(P<0.05);MRI组和常规组的Stroop Color评分明显高于对照组,差异有统计学意义(P<0.05);MRI组和常规组的Stroop Color评分均高于对照组,差异有统计学意义(P<0.05),同时,MRI组的评分也高于常规组,差异有统计学意义(P<0.01);MRI组与常规组的Stroop interference评分均高于对照组,差异有统计学意义(P<0
Objective To investigate the effects of repetitive transcranial magnetic stimulation(rTMS)guided by magnetic resonance imaging(MRI)on the short-trem efficacy and executive function of patients with depression.Methods A total of 59 patients with depression aged 18~50 years who were treated in our hospital from November 2019 to March 2020 were enrolled in the study,who were randomly divided into MRI group(n=19),routine group(n=20)and control group(n=20).The patients in the three groups were treated by SSRIs-like drugs.On this basis,the patients in MRI group were individually localized by using resting-state MRI scans.The patients in routine group were treated by the conventional“5-cm localization method”,and rTMS stimulation frequency was 10Hz,and the stimulation intensity was 100%of the motor threshold,total of 1,500 stimulus pulses,5 times a wek,for 20 times(2 weeks).The patientsin control group were treated by SSRIs only.After 2-wwek treatment the therapeutic effects were assessed by the Hamilton Depression Inventory version 17(HAMD-17),the Connectedness Test(TMT-A)and Stroop Color Word Test(SCWT).Results There were no significant differences in gender,age,education level,family history of depression,and age at first onset among the three groups(P>0.05).After 2-wwek treatment,the total effective rates in MRI group,routine group and control group were 53.64%,20.00%,15.00%,respectively.The therapeutic effects in MRI group were superior to those in routine group and control group(P<0.05).There were no significant differences in TMT-A at baseline,Stroop Word,Stroop Color and Stroop interference among the three groups(P>0.05).Repeated measures ANOVA showed that there were significant time effects in TMT-A,Stroop Word,Stroop Color,and Stroop interference scores(P<0.05).Bronfenni analysis showed that at the end of treatment,the scores of TMT-A,Stroop Word,Stroop Color,Stroop interference in MRI group and routine group were significantly higher than those in control group(P<0.05),moreover,which in MRI group and rout
作者
董震
张云淑
吴涵
王琦
栗克清
DONG Zhen;ZHANG Yunshu;WU Han(Clinical Medical College of Hebei University,Hebei,Baoding 071000,China;不详)
出处
《河北医药》
CAS
2022年第8期1156-1159,共4页
Hebei Medical Journal
基金
河北省医学适用技术跟踪项目(编号:G2019061)。
