重复经颅磁刺激联合治疗对慢性精神分裂症患者认知损害的影响:3个月随访  

Effect of repeated transcranial magnetic stimulation on cognitive impairment in patients with chronic schizophrenia:3-month follow-up

作　　者：周丹[1] 李清伟 陈利群 贾颖婕 张春燕[1] 谢红涛[1] ZHOU Dan;LI Qingwei;CHEN Liqun(Shanghai Putuo Mental Health Center,Putuo 200065,China)

机构地区：[1]上海市普陀区精神卫生中心,同济大学附属同济医院,上海200065

出　　处：《国际精神病学杂志》2024年第4期1069-1074,共6页Journal Of International Psychiatry

基　　金：上海市普陀区卫生系统自主创新科研资助项目(编号:ptkwws201807)。

摘　　要：目的探讨重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合治疗对慢性精神分裂症患者认知功能的影响及其后续效应。方法128例精神分裂症患者按照随机数字表法分为研究组(真刺激)59例和对照组(伪刺激)69例;两组在服用原抗精神病药品种及剂量不变的基础上,在对应的左侧背外侧额叶皮质区给予20Hz真或伪rTMS治疗4周,每周5次。治疗结束后,随访3个月。分别于治疗前后,随访后,用阳性与阴性症状量表(Positive and Negative Syndrome Scale,PANSS),成套神经心理测验量表评估患者精神症状,认知功能改变。结果在精神症状变化方面,两组在PANSS阴性症状评分在不同时间主效应,组间主效应及交互效应上,差异均有统计学意义;在认知功能变化方面,两组即刻记忆,注意力,延迟记忆评分在不同时间主效应,组间主效应及交互效应上,差异均有统计学意义。两组在治疗后(χ2=8.79,P=0.003)及随访后(χ2=4.589,P=0.032),好转率差异存在统计学意义。结论TMS联合治疗对慢性精神分裂症患者认知功能,阴性症状等均有不同程度改善,并表现出一定持久性。Objective To investigate the effects of repeated transcranial magnetic stimulation(rTMS)synergistic therapy on cognitive function in patients with chronic schizophrenia and its subsequent effects.Methods 128 schizophrenic patients were divided into study group(true stimulation)59 cases and control group(false stimulation)69 cases according to random number table method.The two groups were given 20Hz true or pseudo-rTMS in the corresponding left dorsolateral frontal cortex for 4 weeks,5 times a week,on the basis of the same type and dose of the original antipsychotic drug.The patients were followed up for 3 months after treatment.The Positive and negative Symptom Scale(PANSS)and the complete Neuropsychological Scale were used to assess the psychiatric symptoms and cognitive changes before and after treatment and after follow-up.Results In terms of the changes of mental symptoms,the differences of PANSS negative symptom scores in different time main effect,inter-group main effect and interaction effect were statistically significant between the two groups.In terms of cognitive function changes,there were statistically significant differences in the scores of immediate memory,attention and delayed memory in different time main effects,inter-group main effects and interaction effects.After treatment(χ2=8.79,P=0.003)and follow-up(χ2=4.589,P=0.032),the improvement rate of the two groups was statistically significant.Conclusion rTMS synergistic therapy can improve cognitive function and negative symptoms in patients with chronic schizophrenia to varying degrees,and show a certain persistence.

关 键 词：重复经颅磁刺激 精神分裂症 认知功能 

分 类 号：R749.3[医药卫生—神经病学与精神病学]