不同模式经颅磁刺激对甲基苯丙胺依赖者冲动性及渴求的影响  

Effects of different modes of transcranial magnetic stimulation on impulsivity and craving in methamphetamine-dependent individuals

作　　者：任子旋 邱静雅 王妍 王宇婧 王立金 牛守民 许华山 REN Zixuan;QIU Jingya;WANG Yan;WANG Yujing;WANG Lijin;NIU Shoumin;XU Huashan(School of Mental Health,Bengbu Medical University,Bengbu Anhui 233030;Compulsory Isolated Drug Rehabilitation Center,Bengbu Anhui 233000,China)

机构地区：[1]蚌埠医科大学精神卫生学院,安徽蚌埠233030 [2]安徽省蚌埠市强制隔离戒毒所,233000

出　　处：《蚌埠医学院学报》2024年第4期526-531,共6页Journal of Bengbu Medical College

基　　金：蚌埠医学院研究生科研创新计划项目(Byycx20048);安徽省高校自然科学研究重点项目(KJ2018A1017);蚌埠医学院自然科学研究重点项目(2020byzd021)。

摘　　要：目的:研究甲基苯丙胺(MA)依赖者与健康人群冲动性的差异,探讨高频10 Hz模式重复经颅磁刺激(rTMS)和间歇性爆发性theta脉冲刺激(iTBS)对MA依赖者冲动性及渴求的影响。方法:将安徽省某戒毒所中进行戒断治疗的75例MA依赖者采用随机数字表方法分为假刺激组、rTMS组、iTBS组3组。在经颅磁刺激治疗前后全体实验对象均接受Barratt冲动性量表(BIS-11)和VAS量表测量。从社会上招募与MA依赖者一般情况相匹配的50名健康成年男性,作为健康对照组。结果:MA依赖组在运动冲动性和总分均高于健康对照组(P<0.01)。治疗4周后,rTMS组和iTBS组渴求、运动冲动性及总分得分均降低(P<0.05~P<0.01);假刺激组治疗前后得分差异无统计学意义(P>0.05);组间比较发现,rTMS组治疗后的运动冲动性和总分低于假刺激组(P<0.05),iTBS组治疗后的运动冲动性、认知冲动性、无计划冲动性及总分低于假刺激组(P<0.05~P<0.01);3组在治疗后渴求差异无统计学意义(P>0.05)。iTBS组中运动、认知和总分冲动减分率明显高于假刺激组(P<0.01),而rTMS组运动和总分冲动减分率高于假刺激组(P<0.05~P<0.01);3组渴求变化量差异无统计学意义(P>0.05)。结论:MA依赖者有着高水平的冲动性。iTBS和10Hz rTMS均有助于降低依赖者冲动性及渴求,两种模式的治疗效果相当。Objective:To investigate the differences in impulsivity between methamphetamine(MA)-dependent and healthy populations,as well as to explore the effects of high-frequency 10 Hz mode repetitive transcranial magnetic stimulation(rTMS)and intermittent theta burst stimulation(iTBS)on impulsivity and craving in MA-dependent individuals.Methods:Seventy-five MA-dependent subjects undergoing withdrawal treatment in a drug rehabilitation facility in Anhui province were divided into three groups using a random number table method:the sham stimulation group,the rTMS group and the iTBS group.All subjects received the Barratt impulsiveness scale(BIS-11)and the VAS scale before and after transcranial magnetic therapy.Fifty healthy adult males matched to the general profile of MA-dependent individuals were recruited from the community and served as healthy controls.Results:The motor impulsivity and total score of the MA-dependent group were higher than those of the healthy control group(P<0.01).After 4 weeks of treatment,both the rTMS and iTBS groups showed a decrease in craving,motor impulsivity,and total score scores(P<0.05 to P<0.01),There was no statistically significant difference in scores between the sham stimulation group before and after treatment(P>0.05),The inter group comparison found that the motor impulsivity and total score of the rTMS group after treatment were lower than those of the sham stimulation group(P<0.05),while the motor impulsivity,cognitive impulsivity,unplanned impulsivity,and total score of the iTBS group after treatment were lower than those of the sham stimulation group(P<0.05 to P<0.01);There was no statistically significant difference in craving among the three groups after treatment(P>0.05).The reduction rates of motor,cognitive,and total impulse scores in the iTBS group were significantly higher than those in the sham stimulation group(P<0.01),while the reduction rates of motor and total impulse scores in the rTMS group were higher than those in the sham stimulation group(P<0.05 to P<0.01).The

关 键 词：甲基苯丙胺依赖 重复经颅磁刺激 冲动性 渴求 

分 类 号：R749.64[医药卫生—神经病学与精神病学]