重复经颅磁刺激对阿尔茨海默病患者精神行为症状的疗效分析  

Effect of repetitive transcranial magnetic stimulation （rTMS） for behavioral and psychological symptoms of dementia（BPSD） of Alzheimer disease

作　　者：杨婵娟[1] 张若曦[1] 方雅秀[1] 王丹逢[1] 郭家伶 韩海英[1] 刘文滔[1] 谭燕[1] 

机构地区：[1]广州市脑科医院,510370

出　　处：《神经疾病与精神卫生》2014年第5期454-456,共3页Journal of Neuroscience and Mental Health

摘　　要：目的 探讨重复经颅磁刺激（rTMS）对轻、中度阿尔茨海默病（AD）患者精神行为症状（BPSD）的疗效.方法 将38例有BPSD的AD患者随机分为rTMS治疗组（20例）和对照组（18例）,分别接受20次5 Hz rTMS真刺激和伪刺激治疗,治疗期间维持原有的胆碱酯酶抑制剂治疗.治疗前及治疗后2周、6周采用神经精神科问卷（NPI）观察疗效,采用治疗不良反应量表（TESS）观察不良反应.结果 38例患者均完成治疗,治疗6周时治疗组NPI评分（16.69±6.62）分较治疗前（27.65±4.38）分明显降低,差异有统计学意义（t=6.16,P＜0.05）;且显著低于对照组（23.44±5.49）分,差异有统计学意义（t=3.33,P＜0.05）.两组TESS总评分比较差异无统计学意义（x^2=2.06,P＞0.05）.结论 rTMS可能是控制轻、中度AD患者BPSD的一种有效而安全的治疗方法.Objective To explore the effects of repetitive Transcranial Magnetic Stimulation （rTMS） in treatment of behavioral and psychological symptoms of dementia （BPSD） of patients with mild- to--moderate Alzheimer disease （AD）. Methods Totals of 38 mild-to-moderate AD patients accompanied with BPSD were randomly divided into active rTMS group （20 cases） and sham rTMS group （18 cases）. Subjects were treated with rTMS respectively for 20 times during 6 weeks. All patients were received with stable cholinesterase inhibitors. Neuropsychiatric Inventory （NPI） was assessed before treatment and 2 weeks and 6 weeks after treatment. The Treatment Emergent Symptom Scale （TESS） was evaluated for side effects. Results All subjects completed the trial. The NPI improved significantly after 6 weeks of active treatment group（16.69±6.62）compared with that of before treatment（27.65±4.38） and sham group（23.44±5.49）, the differences were statistical significantly （t = 6.16,3.33, respectively; P〈 0.05）. There was no statistical significance in TESS between two groups （x^2 = 2.06,P 〉 0.05）. Conclusions In this study, rTMS seems a promising effective and safe therapies for BPSD of mild- to- moderate AD.

关 键 词：重复经颅磁刺激 阿尔茨海默病 精神行为症状 

分 类 号：R749.16[医药卫生—神经病学与精神病学]