双相障碍躁狂发作患者皮层抑制功能改变  

Cortical inhibitory dysfunction in patients with mania

作　　者：陈珊 唐莺莹[2] 王继军[2] 钱禛颖 盛建华[1] HEN Shan;TANG Yingying;WANG Jijun;QIAN Zhenying;SHENG Jianhua(Shanghai Jiaotong University affiliated Mental Health Center,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心临床四科 [2]上海交通大学医学院附属精神卫生中心脑电影像眼动研究室

出　　处：《中国神经精神疾病杂志》2020年第9期526-530,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：上海市科学技术委员会西医引导类课题(编号:17411969900);上海市卫生和计划生育委员会卫生行业临床研究专项(编号:201840269)。

摘　　要：目的探索双相障碍躁狂发作患者的皮层抑制(cortical inhibition,CI)功能损伤。方法采用经颅磁刺激技术对21例双相障碍躁狂发作患者与19名健康对照进行CI功能指标检测,包括静息运动阈值(resting motor threshold,RMT)、皮质静息期(cortical silent period,CSP)、短间隔皮层间抑制(short-interval cortical inhibition,SICI)以及皮质间易化(intra-cortical facilitation,ICF)。根据是否使用传统心境稳定剂(mood stabilizers,MS)将患者组分为两个亚组,分析各组之间CI功能指标的差异。结果未使用MS躁狂患者组RMT低于使用MS组和对照组[30.1%±1.1%vs.38.2%±2.5%vs.37.1%±1.4%,P<0.05],未使用MS躁狂患者组SICI亦低于使用MS组和对照组[0.2(0.2,0.4)vs.0.5(0.3,0.7)vs.0.4(0.3,0.8),P<0.05],而使用MS躁狂患者组和对照组之间RMT、SICI差异均无统计学意义(P>0.05),三组间CSP、ICF差异无统计学意义(P>0.05)。结论躁狂患者的CI功能受损,而使用MS可能会对躁狂患者的CI功能产生一定影响。Objective To investigate the impaired cortex cortical inhibition(CI)function in patients with mania.Methods Twenty-one patients with mania and 19 healthy controls were enrolled.Transcranial magnetic stimulation technology was used to measure CI function,indicated by resting motor threshold(RMT),cortical silent period(CSP),short-interval cortical inhibition(SICI)and intra-cortical facilitation(ICF).Manic patients were divided into two subgroups based on whether Mood Stabilizers(MS)were used or not.The difference between these groups were further analyzed.Results RMT was lower in manic patients without MS than in those with MS and the healthy controls(30.1%±1.1%vs.38.2%±2.5%vs.37.1%±1.4%,P<0.05).SICI was also lower in manic patients without MS than those with MS and the healthy controls[0.2(0.2,0.4)vs.0.5(0.3,0.7)vs.0.4(0.3,0.8),P<0.05],while RMT and SICI were not significantly different between manic patients with MS and healthy controls(P>0.05).Conclusion The CI function is impaired in manic patients,while MS may have some effects on CI function of manic patients.

关 键 词：双相障碍 诱发电位 皮质兴奋性 神经抑制 

分 类 号：R749.4[医药卫生—神经病学与精神病学]