重复经颅磁刺激对催乳素及事件相关电位P300的影响

The effect of repetitive transcranial magnetic stimulation on serum prolactin levels and event-related potential P300

目的:探讨重复经颅磁刺激(rTMS)对男性精神分裂症患者血清催乳素(PRL)水平及事件相关电位P300的影响。方法:将43例男性精神分裂症患者随机分为rTMS组(21例)和对照组(22例)。rTMS组在稳定剂量的利培酮3～6 mg/d治疗的同时给予连续5 d的高频rTMS刺激,对照组采用假rTMS刺激。刺激前后对两组分别进行血清PRL测定、P300检查及阳性和阴性症状量表(PANSS)、17项汉密尔顿抑郁量表(HAMD)评定。结果:刺激前两组PRL水平差异无统计学意义(P>0.05);治疗后,rTMS组PRL水平高于治疗前,差异有统计学意义(P<0.01);与治疗前比较,治疗后在CZ点,rTMS组P300的P2、P3波幅升高(P均<0.01)。而对照组P300各项指标治疗前后变化均无统计学意义(P均>0.05)。与治疗前比较,治疗后rTMS组及对照组PANSS总分及各因子分变化均无统计学意义(P均>0.05)。rTMS组治疗后HAMD评分下降(P<0.05)。结论:高频rTMS可使男性精神分裂症患者P300的P2、P3波幅升高,改善患者的认知功能及抑郁情绪。但同时会使血清PRL水平增高。

Objective： To explore the effects of repetitive transcranial magnetic stimulation （rTMS） on se- rum prolactin（PRL） and the event-related potential P300 in male patients with schizophrenia. Method： Forty-three male patients with schizophrenia were randomly assigned to active rapid rTMS group （21 cases）and sham rTMS group（22 cases）. All the patients with risperidone（3 -6 mg/d）were examined with serum prolactin,P300, the positive and negative syndrome scale （PANSS）and 17-item hamilton depression rating scale （HAMD） before and after 5 daily rapid rTMS. Results：The baseline serum prolactin in patients was not sig- nificantly different from that in controls（ P 〉 0.05 ）, but was significantly increased after rTMS（ P 〈 0.01 ）. The amplitude of waves P2 ,P3 was heightened after rTMS（ P 〈0.01 ） ,while there was no significant difference com- pared with controls （ P 〉 0.05 ）. PANSS scores were not significantly different after rTMS between the two groups （ P 〉 0.05 ）, while the HAMD scores was only decreased in active rTMS group （ P 〈 0.05 ）. Conclusion ： Rapid rTMS is effective in treatment of cognitive impairment（ higher P2 ,P3 wave amplitude）and depression in male patients with schizophrenia, but can also increase serum prolactin levels.