左侧背外侧前额叶高频重复经颅磁刺激对青少年网络游戏障碍的疗效  

The effect of high-frequency repetitive transcranial magnetic stimulation on the left dorsolateral prefrontal cortex in young and adolescent with internet gaming disorders

作　　者：孙继军[1] 朱春燕[2] 胡楠楠 王卓 方玲 张军 贾娜娜 盘圣明[1] SUN Ji-jun;ZHU Chun-yan;HU Nan-nan;WANG Zhuo;FANG Ling;ZHANG Jun;JIA Na-na;PAN Sheng-ming(The Seventh people's Hospital of Hangzhou,Hangzhou 310000,China)

机构地区：[1]杭州市第七人民医院精神三科,浙江省杭州市310000 [2]杭州市第七人民医院精神六科,浙江省杭州市310000

出　　处：《临床精神医学杂志》2022年第4期272-275,共4页Journal of Clinical Psychiatry

基　　金：浙江省医药卫生科技计划(2020KY743/2020363968)。

摘　　要：目的:探讨左侧背外侧前额叶高频重复经颅磁刺激(rTMS)对青少年网络游戏障碍的疗效。方法:61例青少年网络游戏障碍者,随机分为真刺激组30例和伪刺激组31例,分别于rTMS治疗前后进行中文网络成瘾量表(CIAS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、可视化渴求量表(VAS)评定,并与25名正常对照组比较,同时分析各量表评分之间的相关性。结果:治疗后真刺激组CIAS总分及其他因子分、HAMD和HAMA评分均较治疗前下降(P<0.05),但仍高于对照组(P<0.05);VAS评分均较治疗前下降(P<0.05)。治疗后真刺激组的CIAS总分、强迫、戒断反应、时间管理因子分、HAMD、HAMA、VAS均显著低于伪刺激组(P<0.05)。所有患者的HAMD评分与CIAS总分及时间管理问题因子分呈正相关(P<0.05);HAMA评分与CIAS总分、强迫性上网、戒断反应、人际与健康问题及时间管理呈正相关(P<0.05);VAS评分与CIAS总分、强迫性上网、戒断反应及时间管理问题呈正相关(P<0.05)。结论:左侧背外侧前额叶高频rTMS有助于改善网络游戏障碍患者的渴求及成瘾行为,改善焦虑、抑郁情绪。Objective:To explore the effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)on the left dorsolateral prefrontal cortex in young and adolescent with Internet gaming disorders.Method:61 young or adolescents with Internet gaming disorders were randomly divided into genuine stimulation group(n=30)and a pseudo-stimulation group(n=31).The Chinese version of Internet Addiction Scale(CIAS),Visual Analogue Scale(VAS),Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)were used for evaluation before and after rTMS treatment.The results were compared with 25 health controls,and the correlation among these scale scores were analysed.Results:In genuine stimulation group,the total CIAS score,other factor scores,HAMD and HAMA scores were all significantly lower after treatment(P<0.05),but still higher than those in control group(P<0.05),VAS scores were lower after treatment(P<0.05).The total score of CIAS,compulsive,withdrawal response,time management factors,and HAMD,HAMA and VAS scores in the genuine-stimulation group were lower than those in pseudo-stimulation group after treatment(P<0.05).The HAMD scores of all patients were positively correlated with CIAS total scores and time management problem factor scores(P<0.05);HAMA scores were positively correlated with CIAS total scores,compulsive Internet access,withdrawal reactions,interpersonal and health problems,and time management factors(P<0.05);VAS score was positively correlated with CIAS total score,compulsive Internet access,withdrawal response and time management problems(P<0.05).Conclusion:High-frequency rTMS on the left dorsolateral prefrontal cortex can help to improve the craving and addictive behaviors of patients with Internet gaming disorder,and improve anxiety and depression.

关 键 词：网络游戏障碍 高频重复经颅磁刺激 左侧背外侧前额叶 渴求 抑郁 焦虑 

分 类 号：R749[医药卫生—神经病学与精神病学]