高频重复经颅磁刺激对酒精依赖患者执行功能及氧化应激指标的影响  

The effects of high frequency repetitive transcranial magnetic stimulation on executive function and oxidative stress in patients with alcohol dependence

作　　者：刘林晶[1] 潘建设[1] 朱程[1] 郑克[1] 刘家洪[1] 叶敏捷[1] 

机构地区：[1]温州医科大学附属康宁医院精神科,浙江温州325007

出　　处：《温州医科大学学报》2017年第5期347-351,共5页Journal of Wenzhou Medical University

基　　金：温州市科技局科研基金资助项目(Y20140421)

摘　　要：目的:探讨高频重复经颅磁刺激(r TMS)对酒精依赖患者执行功能及氧化应激指标的影响,并进一步分析治疗过程中执行功能的改变与氧化应激水平改变的关系。方法:连续入组男性酒精依赖戒断期后(停止饮酒14 d以上)患者200例,按照就诊号随机分为真刺激组和伪刺激组,真刺激组给予4周的r TMS治疗,伪刺激组给予同等程度的伪刺激,在治疗前和治疗4周后检测血浆中的主要氧化应激指标:超氧化物歧化酶(SOD)活性,谷胱甘肽过氧化物酶(GSH-Px)和丙二醛(MDA)的含量,同时用执行功能行为评定量表成人版(BRIEF-A)评估2组患者症状。结果:2组治疗前BRIEF-A总分和因子分以及氧化应激指标差异无统计学意义(P>0.05);治疗4周后真刺激组BRIEF-A总分和因子分以及MDA含量低于伪刺激组和治疗前,SOD和GSHPx含量高于伪刺激组和治疗前(P<0.05);真刺激组BRIEF-A总分和因子分以及氧化应激指标的差值高于伪刺激组(P<0.05);MDA差值和GSH-Px差值与BRIEF-A总分及因子分差值呈显著正相关,MDA差值和GSH-Px差值可以分别解释BRIEF-A总分差值变异的21.30%和7.10%(P<0.05)。结论:高频r TMS可以显著改善酒精依赖患者的执行功能,改变血浆中氧化应激指标的含量,在r TMS治疗过程中体内MDA和GSH-Px含量的变化可能与执行功能的改善有关。Objective： To investigate the effects of high frequency repetitive transcranial magnetic （rTMS） on the executive function and oxidative stress in patients with alcohol dependence, and to analyze the relation-ship between the changes of executive function and the changes of oxidative stress during the treatment process. Methods： Two hundreds patients with alcohol dependence after withdrawal period （stop drinking more than 14 days） were randomly divided into real rTMS group and sham rTMS group according to the visiting number. The patients in real rTMS group were treated with 10 Hz rTMS for 4 weeks, while the patients in sham rTMS group were given the same degree of pseudo stimulation. The oxidative stress level of superoxide dismutase （SOD）, glutathione peroxidase （GSH-Px） and malondialdehyde （MDA） and the score of behavior rating inventory of executive function-adult version （BRIEF-A） were measured before and after 4 weeks’ treatments in patients with alcohol dependence. The data of two groups were collected and analyzed by SPSS20.0. Results： Before the treatment, the BRIEF-A total score and its factor score and the serum level of SOD, GSH-Px and MDA between real rTMS group and sham rTMS group had no signifcant differences （P〉0.05）; After 4 weeks’ treatments, the BRIEF-A total score and its factor score and the serum level of MDA in real rTMS group were much lower than that of sham rTMS group and that of before treatments, while the serum level of SOD and GSH-Px in real rTMS group was much higher than that of sham rTMS group and that of before treatments. Compared to the sham rT-MS group, the changes of BRIEF-A total score and its factor score and the level of oxidative stress in real rTMS group were signifcantly higher （P〈0.05）; The change level of MAD and GSH-Px were positively correlated with the the changes of BRIEF-A total score and its factor score, while the change level of MAD and GSH-Px couldexplain 21.30% and 7.10% of the reduction of BRIEF-A total score res

关 键 词：酒精依赖 重复经颅磁刺激 氧化应激 执行功能 

分 类 号：R749.6[医药卫生—神经病学与精神病学]