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重复经颅磁刺激治疗脑卒中后抑郁的临床疗效及磁共振波谱分析

  

  1. 黄石市中心医院 老年病科,湖北 黄石 435000
  • 出版日期:2016-05-05 发布日期:2016-05-04
  • 通讯作者: 田青,Email:zhanglihui10510@163.com

Clinical efficacy of repetitive transcranial magnetic stimulation in treatment of post stroke depression and magnetic resonance spectroscopy analysis

  1. Department of Geratology,Huangshi Central Hospital,Huangshi 435000, China
  • Online:2016-05-05 Published:2016-05-04
  • Contact: Corresponding author:Tian Qing,Email:zhanglihui10510@163.com

摘要: 目的 探讨不同频率的重复经颅磁刺激(rTMS)对脑卒中后抑郁(PSD)的治疗效果,氢质子磁共振波谱
(1H-MRS)对于该疗效的评价价值。方法 连续选取脑卒中后抑郁患者73例,根据中国精神疾病分类方案与诊断标
准第3版,以分层区组随机化分组法,将患者分为高频刺激组(24例),低频刺激组(24例),假刺激组(25例)。前2组
分别接受rTMS高频刺激和低频刺激治疗,分别在入组时和治疗4周后给予汉密顿抑郁量表(HAMD)检查,假刺激
组给予和高频刺激组相同频率的声音,但是没有磁刺激,并在治疗4周后给予1H-MRS检查,对各组结果进行统计分
析。结果 ①治疗后,高频刺激组HAMD评分(13.5±1.6)分和低频刺激组(13.1±1.7)分降低,两组之间差异无统
计学意义,但两组与假刺激组(16.3±1.4)分比较差异有统计学意义(P <0.01),假刺激组HAMD评分改善不显著。
②治疗后,3组患者之间双侧额叶、丘脑和海马的Cho/Cr比值差异无统计学意义(P >0.05)。结论 rTMS高频和
低频刺激均能改善PSD患者抑郁状况,未发现两者之间有显著差异。

关键词: 脑血管意外, 抑郁, 磁疗法

Abstract:

Objective  To investigate the effect of different frequency repetitive transcranial magnetic stimulation (rTMS) in patients with post stroke depression(PSD). Methods  Seventythree PSD patients who met  the third edition of the Chinese Classification of Mental Disorders(CCMDⅢ),were examined by Hamilton Depression Scale (HAMD) at enrollment and four weeks after treatment,and examined by proton magnetic resonance spectroscopy (1HMRS) four weeks after treatment.The patients were divided into high frequency group(24 cases),low frequency group(24cases) and sham stimulation group(25 cases),the former two groups respectively got rTMS high or low frequency treatment. But sham stimulation group was giren the sounds of same frequency as high frequency groups,but no magnetic stimulation. Results  ① After treatment, HAMD score reduced in high frequency group (13.5±1.6) scores and low frequency group (13.1±1.7) scores, there was no significant difference between two groups.The difference was statistically significant between the two groups and the sham stimulation group (16.3±1.4) scores (P<0.01).The HAMD score of sham group was not significantly improved. ② After treatment, there were no significant difference in Cho/Cr ratio between the three groups of patients with frontal lobe, hippocampus japonicas and thalamus (P>0.05). Conclusion  Both high frequency of  rTMS  and low frequency can improve the status of depression in patients with PSD.There were no significant differences between  two groups.

Key words: cerebrovascular accident, depression, magnetotherapy