经颅磁刺激评估抑郁症患者皮层兴奋抑制性及其与症状严重程度的相关性  

Cortical excitability and inhibition in patients with major depression and its correlation with depression severity as measured by transcranial magnetic stimulation

作　　者：黄佳茜 李涓[2] 邹可[1] 金荣疆[2] 郑重[1] HUANG Jiaxi;LI Juan;ZOU Ke(West China Hospital of Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学华西医院,四川成都610041 [2]成都中医药大学

出　　处：《精神医学杂志》2022年第1期14-18,共5页Journal of Psychiatry

基　　金：国家自然科学基金面上项目(编号:81873354);四川省科技厅重点研发项目(编号:2020YFS0284)。

摘　　要：目的采用经颅磁刺激技术(TMS)探讨抑郁症患者和健康人大脑运动皮层兴奋抑制性差异及其与症状严重程度的关系。方法选取抑郁症患者和年龄、性别匹配的健康人各40例,采用单脉冲和成对脉冲TMS检测左、右半球运动皮层兴奋抑制性,检测指标包括静息运动阈值(RMT),皮质静息期(CSP),刺激间隔为1 ms和2 ms的皮质内抑制(ICI),刺激间隔为12 ms和15 ms的皮质内易化(ICF)。采用24项汉密尔顿抑郁量表(HAMD-24)评估抑郁症状严重程度。结果患者组左半球ICI-1ms、ICI-2ms测量值均高于健康对照组(P<0.05),而患者组和健康对照组之间的CSP、ICF差异无统计学意义(P>0.05)。患者组左半球CSP时程大于右半球CSP时程(P<0.05)。相关性分析发现,患者组左半球ICI-1ms、ICI-2ms测量值与HAMD-24评分均呈正相关(P<0.05)。结论抑郁症患者左右侧运动皮层功能存在异常的非对称性,左侧半球皮层抑制功能受损,受损程度与症状严重程度存在相关性。Objective To explore differences of cortical excitability and inhibition assessed by methods of transcranial magnetic stimulation(TMS)between patients with depression and healthy controls and to examine their relationships with depression severity.Methods 40 depressed patients and 40 age-and sex-matched healthy controls underwent single-and paired-pulse TMS applied to the left and right motor cortex.Transcranial magnetic stimulation measures included rest motor threshold(RMT),cortical silent period(CSP),intracortical inhibition(ICI)at 1-ms and 2-ms interstimulus intervals and intracortical facilitation(ICF)at 12-ms and 15-ms interstimulus intervals.Depression symptom severity was measured with Hamilton Depression Scale-24 item(HAMD-24).Results Compared with healthy controls,patients with depression demonstrated significantly increased ICI-1ms and ICI-2ms values in left hemisphere(P<0.05),while CSP and ICF showed no significant differences between depressed patients and healthy controls(P>0.05).Patients with depression showed a significant hemispheric asymmetry in CSP(P<0.05).Correlation analysis found that the values of ICI-1ms and ICI-2ms in the left hemisphere of patients with depression were positively correlated with the total score of HAMD-24(P<0.05).Conclusion These results provide evidence for the hemispheric asymmetry in motor cortical inhibition of patients with depression.There exists a relationship between depression severity and inhibitory deficits in the left hemisphere of patients with depression.

关 键 词：抑郁症 经颅磁刺激 皮层兴奋性 皮层抑制性 

分 类 号：R749.4[医药卫生—神经病学与精神病学]