经颅直流电刺激对精神分裂症伴迟发性运动障碍患者空间工作记忆的影响  

Effects of transcranial direct current stimulation on spatial working memory in schizophrenic patients with tardive dyskinesia

作　　者：赵雪莉 方晓佳 吕笑丽 岳彦 袁念 李哲[2] 陈思宇 张文跃[4] 黄晓霞 杜向东 Zhao Xueli;Fang Xiaojia;Lyu Xiaoli;Yue Yan;Yuan Nian;Li Zhe;Chen Siyu;Zhang Wenyue;Huang Xiaoxia;Du Xiangdong(Xuzhou Medical University,Xuzhou 221004,China;Suzhou Guangji Hospital,Soochow University,Suzhou 215000,China;Nanchong Physical and Mental Hospital,Nanchong 637000,China;Taicang Third People's Hospital,Taicang 215400,China;Suzhou Social Welfare Home,Suzhou 215000,China)

机构地区：[1]徐州医科大学,221004 [2]苏州大学附属苏州市广济医院,215000 [3]南充市身心医院,637000 [4]江苏省太仓市第三人民医院,215400 [5]苏州市社会福利总院,215000

出　　处：《神经疾病与精神卫生》2021年第7期468-472,共5页Journal of Neuroscience and Mental Health

基　　金：苏州市科技计划项目(SS201752,SS202069)。

摘　　要：目的探讨经颅直流电刺激(tDCS)对精神分裂症伴迟发性运动障碍(TD)患者空间工作记忆的影响。方法选取2017年6月至2018年1月来源于苏州市广济医院、苏州市社会福利总院、太仓市精神卫生中心、南充市第六人民医院四家精神专科医院的38例住院精神分裂症伴TD患者,随机分为试验组(21例)和对照组(17例)。研究期间,两组患者均接受常规药物治疗,试验组予以tDCS治疗,采用的电流为2 mA,刺激部位为左侧背外侧前额叶皮质及对侧眶上缘;对照组相应地予以伪tDCS治疗。在基线期、治疗15次结束后及2周后进行随访,采用剑桥神经心理自动化成套测试(CANTAB)中的空间工作记忆(SWM)模块分别对两组患者进行认知测评。结果在完成15次治疗后,试验组SWM指标分析中的总错误数[31.00(28.50,49.00)]、平均第一次响应时间(4盒子)[3289.500(1871.750,5018.000)ms]、平均第一次响应时间(6盒子)[2862.500(2128.500,4672.250)ms]、平均第一次响应时间(8盒子)[3328.500(2611.250,5120.750)ms]与对照组比较,差异无统计学意义(P>0.05);试验组SWM指标分析中的策略分[19.00(17.00,20.00)]低于对照组[21.00(19.50,23.00)],差异有统计学意义(P<0.05)。在2周后的随访中,两组的SWM各指标比较,差异均无统计学意义(P>0.05)。结论tDCS可能对精神分裂症患者使用策略的能力有即刻改善效应。Objective To explore the effect of transcranial direct current stimulation(tDCS)on spatial working memory in schizophrenic patients with tardive dyskinesia(TD).Methods A total of 38 schizophrenic patients with TD from Suzhou Guangji Hospital,Suzhou Social Welfare Home,Nanchong Physical and Mental Hospital,and Taicang Third People's Hospital were randomly divided into trail group(21 cases)and control group(17 cases).Both groups received conventional medication therapy.The trail group received tDCS with a current of 2 mA at the left dorsolateral prefrontal cortex and the contralateral supraorbital margin.The control group was treated with sham tDCS for 3 weeks.The patients were followed up at baseline,after the 15th treatment and 2 weeks after treatment.The Spatial Working Memory(SWM)module of the Cambridge Neuropsychological Test Automatic Battery(CANTAB)was used to evaluate the cognition of the patients in both groups.Results After 15 treatments,the total number of errors[31.00(28.50,49.00)],the average first response time(4 boxes)[3289.500(1871.750,5018.000)ms],the average first response time(6 boxes)[2862.500(2128.500,4672.250)ms],the average first response time(8 boxes)[3328.500(2611.250,5120.750)ms],has no statistically significant difference compared with those of the control group(P>0.05).The strategy score of SWM index analysis in the experimental group[19.00(17.00,20.00)]was lower than that in the control group[21.00(19.50,23.00)].The difference was statistically significant(P<0.05).In the followup after 2 weeks,there was no statistically significant difference in SWM between the two groups(P>0.05).Conclusions There may be immediate improvement effect of tDCS on the ability of schizophrenic patients to use strategies.

关 键 词：精神分裂症 经颅直流电刺激 迟发性运动障碍 工作记忆 

分 类 号：R749.3[医药卫生—神经病学与精神病学]