重复经颅磁刺激对精神分裂症患者阴性症状和认知功能的疗效及安全性研究  

Efficacy and safety of repetitive transcranial magnetic stimulation on negative symptoms and cognitive function in patients with schizophrenia

作　　者：封阳[1] 徐静文[1] 管晓波[1] 于士静 刘群[1] FENG Yang;XU Jing-wen;GUAN Xiao-bo;YU Shi-jing;LIU Qun(Rehabilitation Department,Shanghai Civil Affairs Third Mental Health Center,Shanghai 200435,China)

机构地区：[1]上海市民政第三精神卫生中心康复科,200435

出　　处：《临床精神医学杂志》2023年第4期288-291,共4页Journal of Clinical Psychiatry

基　　金：上海市民政局2018年局级课题(3-2-55)。

摘　　要：目的:探讨重复经颅磁刺激(rTMS)改善精神分裂症患者阴性症状及认知功能的疗效及安全性。方法:入组2018年1月至2019年6月上海市民政第三精神卫生中心就诊的90例病程5年以下精神分裂症患者,给予利培酮药物维持治疗,后随机分为rTMS组(n=47)和伪刺激组(n=43),分别于治疗前、治疗4周末、治疗8周末对研究对象行阳性和阴性综合量表(PANSS)、神经心理状态评定量表(RBANS)测试,比较两组间各变量治疗前后的差异。结果:治疗4周后,rTMS组PANSS量表总分和阴性症状分均低于治疗前,且均低于伪刺激组,差异有统计学意义(P均<0.01)。对分组主效应方差分析发现rTMS组和伪刺激组在PANSS量表阴性分、总分2项和RBANS量表即刻记忆、视空间结构、语言功能、注意力、延迟记忆及RBANS总分6项有统计学差异(P均<0.01)。结论:rTMS治疗对精神分裂症患者阴性症状及认知功能具有改善作用,且疗效有持续效应,安全性好。Objective:To investigate the efficacy and safety of repeated transcranial magnetic stimulation(rTMS)in improving negative symptoms and cognitive function in patients with schizophrenia.Method:A total of 90 patients with schizophrenia with a course of less than 5 years in Shanghai Civil Affairs Third Mental Health Center between January 2018 and June 2019 were assigned to risperidone maintenance therapy and then randomly divided into rTMS group(n=47)and pseudo-stimulus group(n=43).Positive and Negative Symptom Scale(PANSS)and Repeatable Battery for the Assessment of Neuropsyehological Status(RBANS)were tested before treatment,4 weeks after treatment,and 8 weeks after treatment,respectively.The differences of variables before and after treatment between the two groups were compared.Results:After 4 weeks of treatment,the total score of PANSS scale and negative symptom score in rTMS group were lower than before treatment,and both were lower than those in pseudo-stimulus group,the difference was statistically significant(all P<0.01).Analysis of variance on the main effect of the grouping:there were statistical differences between the rTMS group and the pseudo-stimulus group in negative scores and 2 total scores on PANSS and on immediate memory,visuospatial structure,language function,attention,delayed memory and 6 total scores on RBANS(all P<0.01).Conclusion:rTMS therapy can improve the negative symptoms and cognitive function of schizophrenia patients,and the curative effect has a lasting effect and good safety.

关 键 词：重复经颅磁刺激 精神分裂症 阴性症状 认知功能 

分 类 号：R749.3[医药卫生—神经病学与精神病学]