精神分裂症阴性症状重复经颅磁刺激康复治疗效果研究  

The effect of repetitive transcranial magnetic stimulation on the rehabilitation of negative symptoms in patients with schizophrenia

作　　者：叶丹弟 阎同军 胡江燕 陈孙克 田海佳 郑克[1] 李美花 郑天生[1] 章洁 陈兴时[3] 刘圆 YE Dan-di;YAN Tong-jun;HU Jiang-yan;CHEN Sun-ke;TIAN Hai-jia;ZHENG Ke;LI Mei-hua;ZHENG Tian-sheng;ZHANG Jie;CHEN Xing-shi;LIU Yuan(The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder,Wenzhou 325007,China)

机构地区：[1]温州医科大学附属康宁医院、浙江省精神心理疾病临床医学研究中心,325000 [2]联勤保障部队第904医院常州医疗区精神科 [3]上海市精神卫生中心神经生理室 [4]嘉兴市第一医院神经内科

出　　处：《临床精神医学杂志》2024年第3期215-218,共4页Journal of Clinical Psychiatry

基　　金：温州市科技局(Y20220833)。

摘　　要：目的:初步探讨重复经颅磁刺激(repeative transcranial magnetic stimulate, rTMS)对精神分裂症患者阴性症状的治疗效果以及对失匹负波(mismatch neagative, MMN)影响。方法:采用随机数字表法,对康复期精神分裂症患者96例,随机分为3组,分别给予5 Hz、10 Hz和15 Hz的rTMS治疗4周(20次),分别于治疗前后测定并比较患者阴性症状量表(SANS)分值和MMN潜伏期和波幅。结果:与治疗前相比:(1)10 Hz组患者rTMS治疗后SANS量表分值明显下降(P<0.05),而5 Hz和15 Hz组SANS量表分值无明显改善;(2)在中央点(central zero, Cz),10 Hz组患者rTMS治疗后MMN波幅增高(P<0.05),潜伏期无显著变化(P>0.05),其余两组治疗前后MMN潜伏期和波幅均未见明显变化。(3)10 Hz患者组SANS分值的改善状况与患者年龄及病程有关。结论:与5 Hz和15 Hz的rTMS治疗相比,10 Hz的rTMS治疗可改善精神分裂症的阴性症状及认知功能,但这结果是初步的,还有待下一步临床转化中证实。Objective:To investigate the effects of rehabilitation therapy of repetitive transcranial magnetic stimulation(rTMS)on the negative symptoms and on mismatch neagative(MMN)component of MMN in schizophrenia.Method:96 patients with age schizophrenia were randomly divided into 3 groups,treated by 5 Hz,10 Hz and 15 Hz rTMS for 4 weeks(20 times)respectively.The scores of Scale for Assessment of Negative Symptoms(SANS)MMN latency and amplitude before and after were compared before and after the rTMS treatment.Results:①compared with the SANS score before treatment,the score of SANS decreased significantly after rTMS treatment in 10 Hz group(P<0.05),which were not found in 5 Hz and 15 Hz rTMS group;②MMN amplitude in 10 Hz group was increased significantly after rTMS treatment(p<0.05),while the MMN latency was not significantly changed(P>0.05).③The improvement of SANS score in 10 Hz group was related to the age and course of disease.Conclusion:Compared with 5 Hz and 15 Hz rTMS treatment,10 Hz rTMS therapy can effectively improve the negative symptoms and cognitive function of schizophrenia.The mechanism needs further study.

关 键 词：精神分裂症 重复经颅磁刺激 阴性症状 失匹负波 

分 类 号：R749.4[医药卫生—神经病学与精神病学]