高低频率重复经颅磁刺激对老年抑郁症患者的疗效及安全性研究探讨

Efficacy and safety of low frequency repetitive transcranial magnetic stimulation in elderly patients with depression

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2018, 45(6)
作者
作者单位

达州市中心医院门诊部 ;
达州市中心医院 ;

摘要
摘要:目的:观察探讨高低频率重复经颅磁刺激对老年抑郁症患者的疗效及安全性研究探讨。方法:选取我院2015年3月-2016年12月收入精神科的180例老年抑郁症患者,按数值表随机分配法分为三组,三组均给予抗抑郁药物疗程治疗。高频组60例老年抑郁症患者,采取10HZ的高频,90%皮层运动阈值刺激左侧额前叶,低频组60例老年抑郁症患者,采取1HZ的低频,90%皮层运动阈值刺激右侧额前叶,对照组60例老年抑郁症患者,仅采用抗抑郁药物全程治疗。治疗后采用汉密尔顿抑郁量表、贝克抑郁量表( BDI) 、大体功能评定量表( GAF) 及匹茨堡睡眠质量指数量表( PSQI)对患者的抗抑郁效果进行评价,用威斯康星卡片分类测验及持续操作测验评估两组患者的认知功能。结果:高低频率组老年抑郁症患者治疗后汉密尔顿抑郁量表评分各项评分及总分均降低,大体功能评定量表评分均升高,贝克抑郁量表评分均降低,匹茨堡睡眠质量指数量表评分均降低,与对照组相比,差异有统计学意义(P<0.05).但高频组及低频组患者治疗后汉密尔顿抑郁量表各项评分及总分,大体功能评定量表评分,贝克抑郁量表评分及匹茨堡睡眠质量指数量表评分,差异无统计学意义(P>0.05).三组老年抑郁症患者治疗前后威斯康星卡片分类测验总测验次数、正确反应数、持续错误数、随机错误数和分类数等各项目相比,差异无统计学意义(P>0.05).说明重复经颅磁刺激治疗不影响患者的认知能力。三组老年抑郁症患者治疗前后持续操作测验上次测试项目对比等各项目相比,差异无统计学意义(P>0.05). 结论:高频左侧重复经颅磁刺激及低频右侧重复经颅磁刺激均对老年抑郁症患者的抑郁有较好的疗效,比起单纯抗抑郁药物疗程治疗,有效改善患者抑郁心情和睡眠障碍,同时不损害患者认知功能,但高低频率的重复经颅磁刺激并无显著疗效差异,两者均具有临床应用价值。
Abstract
Abstract: Objective: To investigate the effect of repetitive transcranial magnetic stimulation (TMS) on depression, sleep and cognitive function in elderly patients with depression. Methods: 180 elderly patients with depression in our hospital from March 2015 to December -2016 were randomly divided into three groups. The three groups were given antidepressant treatment. 60 cases of senile depression patients with high frequency group, 10HZ high frequency, 90% cortical motor threshold stimulation of the left frontal lobe, 60 cases of elderly patients with depression and low frequency group, 1HZ low frequency, 90% cortical motor threshold stimulating right frontal lobe, the control group of 60 cases of elderly patients with depression, only using antidepressant drug therapy. After treatment with Hamilton depression scale, Beck Depression Scale (BDI), global assessment scale (GAF) and Pittsburgh sleep quality index (PSQI) to evaluate the antidepressant effect of patients, with the Wisconsin Card Sorting Test and continuous performance test evaluation of cognitive function in the patients of the two groups. Results: the low frequency group of elderly patients with depression after treatment, Hamilton Depression Scale score and total score were decreased and the global assessment scale score increased, Beck Depression Scale scores were lower, PSQI score were decreased compared with the control group, the difference was statistically significant (P<0.05). But the high frequency group and low frequency group after treatment in patients with Hamilton Depression Scale score and total score, global assessment scale, Beck depression scale and Pittsburgh sleep quality index score, the difference was not statistically significant (P>0.05). Compared the three groups before and after treatment in elderly patients with depression in Wisconsin Card Sorting Test total number, correct response the number and numbers of persistent error and random error number and classification of the project, there was no statistically significant difference (P>0.05). Repetitive transcranial magnetic Stimulation therapy did not affect patient cognitive ability. The three groups before and after treatment of senile depression patients with continuous performance test project and other projects compared to the last test compared the difference was not statistically significant (P>0.05). Conclusion: high frequency repetitive transcranial magnetic stimulation on the right side of the left side and the low frequency repetitive transcranial magnetic stimulation on depression in elderly patients with depression has better curative effect than single antidepressant treatment. Improve the depression mood and sleep disorders, and does not damage the cognitive function of patients, but low frequency repetitive transcranial magnetic stimulation showed no significant effect, both of which are of clinical value.
关键词
[关键词] 不同频率;重复经颅磁刺激;老年抑郁症;认知功能
KeyWord
[Keywords] different frequencies; repetitive transcranial magnetic stimulation; senile depression; cognitive function
基金项目
页码 1050-1053
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罗爱华*,李丹,王仁昌,卿丹. 高低频率重复经颅磁刺激对老年抑郁症患者的疗效及安全性研究探讨 [J]. 国际精神病学杂志. 2018; 45; (6). 1050 - 1053.

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