左右侧脑电生物反馈治疗广泛性焦虑的随机对照开放研究

A randomized controlled open-label study of right and left lateral EEG biofeedback treatment of generalized anxiety disorder

目的:研究以顶叶α波为训练参数的脑电生物反馈技术对广泛性焦虑的治疗效果,并探讨以左侧顶叶α波为训练参数与以右侧顶叶α波为训练参数的脑电生物反馈技术对广泛性焦虑的疗效是否存在差异。方法:根据美国精神障碍诊断与统计手册第4版(DSM-IV)的诊断标准,选取26名广泛性焦虑女性患者,随机分为左顶叶α波训练组(n=13)和右顶叶α波训练组(n=13),每3天训练1次,每次训练40 min,共训练10次。分别于治疗前、治疗5次后、治疗10次后,采用状态-特质焦虑量表(STAI,包括STAI-S和STAI-T)、贝克抑郁量表第2版(BDI-II)和失眠严重程度指数(ISI)评分以评定其焦虑症状严重程度、抑郁症状严重程度以及失眠症状严重程度。结果:左顶叶α波训练组治疗5次、治疗10次时STAI-S[(38.7±8.8),(35.2±9.2)vs.(47.2±10.7)]、ISI[(13.0±5.2),(8.4±4.7)vs.(17.5±5.3)]评分较治疗前均降低(均P<0.05),而STAI-T、BDI-II评分与治疗前相比差异无统计学意义(均P>0.05)。右顶叶α波训练组治疗5次、治疗10次时STAI-S[(37.3±6.4),(29.9±6.2)vs.(44.9±12.4)]、STAI-T[(40.9±6.4),(36.9±6.9)vs.(47.8±7.5)]、ISI[(10.2±5.1),(6.9±3.1)vs.(15.5±6.9)]评分较治疗前均降低(均P<0.05),治疗10次时BDI-II评分较治疗前显著降低[(10.3±6.0)vs.(17.7±7.2),P<0.05]。结论:以顶叶α波为训练参数的脑电生物反馈技术可能改善女性广泛性焦虑患者的焦虑和失眠症状,以右顶叶α波为训练参数的脑电生物反馈技术还可能改善女性广泛性焦虑患者的焦虑特质和抑郁症状。

Objective：The objective of this research is to investigate the effects of electroencephalogram （EEG） biofeedback training of alpha activity over the parietal lobe in patients with generalized anxiety disorder （GAD）,and to compare the effects of training of alpha activity over the left parietal lobe and right parietal lobe in patients with GAD. Methods： Twenty-six female patients with GAD according to the Diagnostic and Statistical Manual of Mental Disorders （4th edition,DSM-IV） criteria for GAD were included in this study,and these patients were randomized into two groups：the left parietal lobe training group （n=13） and the right parietal lobe training group （n=13）.Patients received a total of 10 times training,in which each training consisted of a 40 minutes training session every three days.The degree of anxiety,depression and insomnia symptoms before the first time training,after the fifth time training and after the last time training were evaluated using the State-Trait Anxiety Inventory （STAI）,Beck Depression Inventory （BDI-II） and Insomnia Severity Index （ISI）. Results： In the left parietal lobe training group,the scores of STAI-S[（38.7±8.8）,（35.2±9.2） vs.（47.2±10.7）,P〈0.05] and ISI[（13.0±5.2）,（8.4±4.7） vs.（17.5±5.3）,P〈0.05] decreased after 5 and 10 times of training.In the right parietal lobe training group,the scores of STAI-S[（37.3±6.4）,（29.9±6.2） vs.（44.9±12.4）,P〈0.05],STAI-T[ （40.9±6.4）,（36.9±6.9） vs.（47.8±7.5）,P〈0.05]and ISI[ （10.2±5.1）,（6.9±3.1） vs.（15.5±6.9）,P〈0.05] decreased after 5 and 10 times of training.The BDI-II scores [（10.3±6.0） vs.（17.7±7.2）,P〈0.05] decreased after 10 times of training. Conclusion： Our findings suggest that EEG biofeedback training of alpha activity over the parietal lobe could improve the anxiety and insomnia symptom in patients with GAD.EEG biofeedback training of alpha activity over the right parietal lobe could also improve their anxiety trait and depressive symptom.