高频重复经颅磁刺激对酒精使用障碍患者饮酒行为和认知功能的疗效  

Efficacy of two-week high-frequency repetitive transcranial magnetic stimulation on drinking behavior and cognitive function in patients with alcohol use disorder

作　　者：张艳[1] 孙玮 伍力 冯祖辛 曾婷婷 元静[1] 王新 金于雄 孟骏宇 付会佐 杨建中[1] ZHANG Yan;SUN Wei;WU Li;FENG Zu-xing;ZENG Ting-ting;YUAN Jing;WANG Xin;JIN Yu-xiong;MENG Jun-yu;FU Hui-zuo;YANG Jian-zhong(The Second Affiliated Hospital of Kunming Medical University,Kunming 650000,China)

机构地区：[1]昆明医科大学第二附属医院,650000 [2]云南省精神病院

出　　处：《临床精神医学杂志》2022年第2期90-93,共4页Journal of Clinical Psychiatry

基　　金：国家重点研发计划项目(2018YFC1314405)。

摘　　要：目的:探讨重复经颅磁刺激(rTMS)对酒精使用障碍(AUD)患者认知功能、饮酒行为和冲动水平的干预效果。方法:84例男性AUD患者,分为实验组(rTMS联合药物治疗组)42例和对照组(药物治疗组)42例。采用饮酒问卷(ADS)与临床酒精戒断状态评估量表(CIWA-Ar)评估患者治疗前酒精依赖水平与是否存在戒断症状;治疗前后分别采用蒙特利尔认知量表(MoCA)评估患者整体认知水平;冲动行为量表(BIS-11)评估患者行为冲动水平;强制饮酒量表(OCDS)评估患者饮酒渴求程度。结果:治疗两周后,实验组的MoCA总分高于对照组,BIS-11总分、认知冲动与无计划冲动水平得分较对照组低(P均<0.01)。实验组OCDS得分低于对照组,差异有统计学意义(P=0.034)。在治疗后,实验组与对照组的MoCA量表总分均有提高(P<0.05)。两组BIS得分、OCDS得分均有下降(P<0.01)。结论:rTMS辅助药物治疗可较好地改善AUD患者认知功能,亦可抑制冲动与降低饮酒渴求。Objective:To explore the intervention effect of rTMS on the cognitive function,drinking behavior and impulse level of alcohol use disorder(AUD)patients.Method:84 male patients with AUD were collected and divided into experimental group(rTMS combined medication treatment)for 42 cases and control group(medication treatment only)for 42 cases.The Alcohol Dependence Scale(ADS)and the Clinical Institute Alcohol Withdrawal Syndrome Scale(CIWA-Ar)were accomplished at baseline to assess the level of alcohol dependence and withdrawal symptoms.Before and after treatment,the Montreal Cognitive Assessment(MoCA)was used to assess the cognitive function;the Barratt Impulsiveness Scale(BIS-11)was used to assess the level of impulsive behavioral;Obsessive compulsive drinking scale(OCDS)was used to assess drinking craving of patients.Results:After two weeks of treatment,the total score of MoCA scale in the experimental group was significantly higher than that in the control group;while total score,cognitive impulse and unplanned impulsivity of BIS was significantly lower than those in the control group(all P<0.01).The OCDS score of the experimental group was significantly lower than that of the control group(P=0.034).After treatment,the total scores of MoCA scale increased and BIS scores decreased in both groups(P<0.05).BIS and OCDS scores decreased in the two groups(P<0.01).Conclusion:rTMS has a good effect in improving the cognitive function,inhibiting impulsivity and reducing drinking cravings for AUD patients.

关 键 词：酒精使用障碍 重复经颅磁刺激 认知功能 

分 类 号：R749.3[医药卫生—神经病学与精神病学]