重复经颅磁刺激对精神分裂症难治性阴性症状及脑源性神经营养因子的影响

发布时间：2018-04-11 22:24

本文选题：经颅磁刺激 + 精神分裂症　；参考：《中国神经精神疾病杂志》2014年12期

【摘要】：目的探讨不同部位重复经颅磁刺激(repetitive transcranial magnetic stimulation,r TMS)对精神分裂症难治性阴性症状及血清脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)的作用特点。方法纳入伴有难治性阴性症状的精神分裂症患者80例,随机分为研究组和对照组,每组各40例,均在维持原药物治疗种类和剂量基础上接受4周10 Hz r TMS治疗,研究组刺激部位为左侧前额叶背外侧皮质(dorsolateral prefrontal cortex,DLPFC),对照组为右侧DLPFC。治疗前、治疗4周末分别进行阳性和阴性症状量表(positive and negative syndrome scale,PANSS)评估和BDNF水平测定。结果治疗前后比较,研究组[(71.2±13.8)vs.(63.3±11.4)]、对照组[(70.3±13.4)vs.(63.7±12.2)]的PANSS总分均降低(P0.05),研究组阴性症状分降低[(22.8±6.6)vs.(18.4±5.9)],且研究组阴性症状分变化值比对照组更大[(4.4±1.9)vs.(2.9±1.2)],差异具有统计学意义(P0.01)。与治疗前比较,治疗后研究组[(6.78±2.16)vs.(8.74±2.76)]和对照组[(6.83±2.32)vs.(8.66±2.70)]BDNF水平均升高(P0.01),但两组变化值无统计学差异(P0.05)。结论联合抗精神病药物,10Hz r TMS作用于精神分裂症患者左侧DLPFC可以改善难治性阴性症状,作用于左侧或右侧DLPFC均能增加血清BDNF水平。
[Abstract]:Objective to explore the different parts of repetitive transcranial magnetic stimulation (repetitive transcranial magnetic stimulation, R TMS) for refractory schizophrenia negative symptoms and serum brain-derived neurotrophic factor (brain-derived neurotrophic, factor, BDNF). The effects of methods into 80 cases of patients with refractory schizophrenia negative symptoms of spirit, random divided into study group and control group, 40 cases in each group, all while maintaining the original medication type and dose of 10 Hz R TMS received 4 weeks of treatment, the study group for the stimulation site left dorsolateral prefrontal cortex (dorsolateral prefrontal, cortex, DLPFC), the control group for the right DLPFC. before treatment, 4 weeks treatment respectively. Positive and negative symptom scale (positive and negative syndrome scale, PANSS) assessment and the level of BDNF. Results: after treatment, the study group [(71.2 + 13.8) vs. (63.3 + 11.4)] and control group [( 70.3 + 13.4) vs. (63.7 + 12.2)] the total score of PANSS decreased (P0.05), the study group of negative symptoms decreased [(22.8 + 6.6) vs. (18.4 + 5.9)], and the study group negative symptom score change value greater than the control group [(4.4 + 1.9) vs. (2.9 + 1.2), the difference was statistically significant (P0.01). Compared with before treatment, after treatment the study group [(6.78 + 2.16) vs. (8.74 + 2.76)] and control group [(6.83 + 2.32) vs. (8.66 + 2.70)]BDNF levels were significantly increased (P0.01), but no significant difference between the two groups change value (P0.05). Conclusion the combination of antipsychotic drugs, 10Hz R TMS in patients with schizophrenia can improve the left DLPFC refractory negative symptom, on the left or right DLPFC could increase the serum level of BDNF.

【作者单位】：解放军第九十一中心医院精神科全军精神疾病防治研究所;
【基金】：全军医学科研计划(编号:CWS12J071)
【分类号】：R749.3

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