低频重复经颅磁刺激对精神分裂症患者血清BDNF水平影响的对照研究  

Clinical control study about the effect of slow repetitive transcranial magnetic stimulation(rTMS) on serum levels of brain-derived neurotrophic factor(BDNF) in schizophrenia

作　　者：刘晓军[1] 

机构地区：[1]胜利石油管理局胜利医院,山东东营257055

出　　处：《精神医学杂志》2011年第3期196-199,共4页Journal of Psychiatry

摘　　要：目的初步探讨低频重复经颅磁刺激(Repetitive transcranial magnetic stimulation,rTMS)治疗对精神分裂症患者血清脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)的影响,以及血清BDNF变化与疗效的相关性。方法 100例伴有幻听症状的精神分裂症患者按1∶1∶1∶1比率随机分为A、B、C、D四组,其中A、C组为典型抗精神病药物治疗;B、D组为非典型抗精神病药物治疗;C、D组合并rTMS治疗。25例正常人作为正常对照组(E组)。真性治疗组给予6周共20次低频(1Hz)rTMS治疗。采用酶联夹心免疫吸附法测定基线、治疗2周、治疗6周的血清BDNF浓度。使用阳性和阴性症状量表(Positive and negative syndrome scale,PANSS)、临床疗效总评量表(Clinical Global Impression,CGI)评估病情严重程度及疗效。以皮尔森相关分析(Pearsoncorrelation)方法来分析血清BDNF水平与疗效之间的相关性。结果与治疗前相比,治疗10次后和20次后D组患者BDNF极显著升高(P<0.001);B、C组治疗后BDNF显著升高(P<0.05);A组治疗前后无显著性差异。D组治疗20次后极显著高于A、B两组(P<0.01)。入组治疗时BDNF与治疗结束时CGI-S评分、CGI-GI评分负相关(r=-0.345,P<0.001;r=-0.217,P<0.05),与治疗前、后PANSS总分负相关(r=-0.202,P<0.05;r=-0.532,P<0.001)。结论低频rTMS治疗能提高精神分裂症血清BDNF浓度,可能有预测疗效的作用。Objective To investigate the effect of slow repetitive Transcranial Magnetic Stimulation（rTMS） on serum levels of brain- derived neurotrophic factor （BDNF） in patients with schizophrenia, and the correlation between serum BDNF levels and the therapeutic effect. Methods One hundred schizophrenia patients with auditory hallucinations were randomly divided into four groups （group A, B, C and D） with the ratio of 1： 1： 1： 1, and 25 normal were as controls （ group E）. Group A and C were treated with typical antipsychotic drugs, group B and D with atypical antipsyehotie drugs, and group C and D with rTMS at the same time. Treatment groups received low - frequency （ 1 Hz） rTMS therapy 20 times for 6 weeks. The level of serum BDNF was determined by Enzyme Linked Immunosorbent Assay（ELISA） before treatment and at the 2nd ,6th weekend after treatment. Positive and Negative symptom scale （PANSS） and Clinical Global Impression（CGI） were used to evaluate the severity and the curative effect. Then Pearson correlation was used to detemine the degree of relationship between the serum BDNF level and the curative effect. Results After the 10th and the 20th time of treatment, the levels of serum BDNF in group D were significantly different compared with that before treatment （P 〈 0. 001 ）, and increased significantly after treatment in group B and C （ P 〈 0.05 ）. There had no significant change after treatment in group A（ P 〉 0.05 ）. At the end of treatment, the level of serum BDNF in group D was significantly higher than that in group A and B （P 〈 0.01 ）. The serum BDNF level at baseline was negatively related to the CGI - S score （ r = - 0. 345, P 〈 0. 001 ）, CGI - GI score （ r = - 0. 217, P 〈 0.05 ） total scores of PANSS at baseline and the end of treatment （ r = - 0. 202, P 〈 0. 05 ; r = - 0. 532, P 〈 0. 001 ）. Conclusion Slow rTMS can increase the levels of serum BDNF in schizophrenia, and may be able to predict the efficacy.

关 键 词：重复经颅磁刺激 脑源性神经营养因子 精神分裂症 皮尔森相关分析 

分 类 号：R749.3[医药卫生—神经病学与精神病学]