高频重复经颅磁刺激(rTMS)和间歇性复合刺激(iTBS)对老年抑郁障碍的干预效果  

Interventional effects of high-frequency repetitive transcranial magnetic stimulation(rTMS)and intermittent compound stimulation(iTBS)on elderly depression disorders

作　　者：张琳 凌云 王丽 刘石密 陈江瑜 张平 Lin ZHANG;Yun LING;Li WANG;Shimi LIU;Jiangyu CHEN;Ping ZHANG(The Second People's Hospital of Guizhou Province,Guiyang 550004,China)

机构地区：[1]贵州省第二人民医院,贵阳550004

出　　处：《阿尔茨海默病及相关病杂志》2024年第1期45-48,共4页Chinese Journal of Alzheimer's Disease and Related Disorders

基　　金：贵州省卫生健康委科学技术基金项目:高频rTMS和iTBS对老年抑郁障碍疗效与认知改善的研究(编号:gzwjkj2020-1-086)。

摘　　要：目的:观察高频重复经颅磁刺激(rTMS)和间歇性复合刺激(iTBS)对老年抑郁与认知改善的疗效观察。方法:选取收治的老年抑郁障碍患者50人,随机分为10 Hz高频rTMS组和iTBS组,在使用舍曲林100 mg/日治疗后分别接受10 Hz高频r TMS和iTBS治疗,脱落10例,最终两组各20例,分别采用自身前后对照进行比较分析。两组分别实施高频rTMS和i TBS治疗,对两组进行疗效比较。结果:治疗10次后,两种治疗方法汉密尔顿抑郁量表(HAMD)评分无统计学意义差异(P> 0.05),而治疗20次后HAMD评分差异有统计学意义(P <0.01)。两种治疗自身前后对比,治疗10次、治疗20次后,HAMD值均低于入院时,有统计学意义(P <0.01),治疗20次对抑郁症状的缓解较治疗10次的明显。两组治疗前TMT1、TMT2、MoCA及VFT基线无统计学差异(P> 0.05),治疗20次后,TMT1、TMT2、MoCA及VFT也均无统计学差异(P> 0.05),自身组内治疗前后对比有统计学差异。结论:经颅磁刺激的两种模式联合舍曲林治疗老年抑郁均有效,在治疗20次后10Hz高频组HAMD分值减少较iTBS组明显,10Hz组对抑郁症状的缓解优于iTBs组,两种治疗对认知均有改善作用,疗效差别无统计学意义。Objective:Observation of the therapeutic effects of high-frequency repetitive transcranial magnetic stimulation(rTMS)and intermittent complex stimulation(iTBS)on depression and cognitive improvement in elderly patients.Methods:Fifty elderly patients with depressive disorders were selected and randomly divided into a 10Hz high-frequency rTMS group and an iTBS group.After receiving treatment with 100mg/day of sertraline,10 patients were treated with 10Hz high-frequency rTMS and iTBS,respectively.Finally,20 patients were removed from each group.The results were compared and analyzed for the efficacy of different treatment modes between the two groups.Results:After 10 treatments,there was no statistically significant difference in the Hamilton Depression Rating Scale(HAMD)between the two treatment methods(P>0.05),while after 20 treatments,there was a statistically significant difference in HAMD between the two treatment,methods(P<0.01).Compared before and after the two treatments,the HAMD values after 10 and 20 treatments were lower than those at admission(P<0.01),and the relief of depressive symptoms was more significant after 20 treatments than after 10 treatments.There was no statistically significant difference in baseline TMT1,TMT2,MoCA,and VFT between the two groups before treatment(P>0.05),and there was no statistically significant difference in TMT1,TMT2,MoCA,and VFT after 20 treatments(P>0.05).There was a statistically significant difference between the two groups before and after treatment.Conclusion:Both modes of transcranial magnetic stimulation combined with sertraline are effective in treating elderly depression.After 20 treatments,the HAMD score of the 10Hz high-frequency group decreased significantly compared to the iTBS group.The 10Hz group had better relief of depressive symptoms than the iTBs group,and both treatments had an improvement effect on cognition,with no statistically significant difference in efficacy.

关 键 词：经颅磁刺激 老年抑郁障碍 舍曲林 认知障碍 

分 类 号：R749.4[医药卫生—神经病学与精神病学]