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探讨

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

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。方法选取我院2016年3月～2018年3月收入心身医学科的180例老年抑郁症患者,按数值表随机分配法分为三组,均给予抗抑郁药物治疗。高频组采取10HZ的高频,90%皮层运动阈值的强度刺激左侧额前叶,低频组采取1HZ的低频,90%皮层运动阈值强度刺激右侧额前叶,对照组仅采用药物治疗。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,GAF评分均升高,BDI评分均降低,PSQI评分均降低,治疗后高、低频率组的疗效均优于对照组(P<0.05)。三组患者治疗前后威斯康星卡片分类测验各项目相比无明显差异(P>0.05)。结论高频左侧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,有效改善患者抑郁心情和睡眠障碍。

Objective To investigate the efficacy and safety of low and high frequency repetitive transcranial magnetic stimulation(rTMS)in the treatment of senile depression. Methods 180 elderly patients with depression in our hospital from March 2016 to March-2018 were randomly divided into three groups. They were all given antidepressant treatment. High frequency group were given high frequency(10 HZ)rTMS,while low-frequency group were given low frequency(1 HZ)rTMS,and the control group only used antidepressant medication. The Hamilton depression scale,Beck Depression Scale(BDI),global assessment scale(GAF)and Pittsburgh sleep quality index(PSQI)to evaluate the antidepressant effect of patients,the Wisconsin Card Sorting Test and continuous performance test to evaluate of cognitive function for all the patients. Results After treatment,compared with the control group,the low and high frequency group in patients with Hamilton Depression Scale score and total score were decreased and the GAF score increased,BDI decreased,PSQI scores were reduced(P<0.05). There were no different in Wisconsin card sorting test items among three groups(P >0.05). Conclusion Both high and low frequency rTMS can effectively improve depressive mood and sleep disorder.