重复经颅磁刺激对精神分裂症患者认知功能的影响

Effect of repetitive transcranial magnetic stimulation on cognitive function in patients with schizophrenia

目的探讨高频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对精神分裂症患者认知功能的影响。方法 71例精神分裂症患者随机分为观察组36例和对照组35例,在利培酮抗精神病治疗同时,观察组和对照组分别给予4周10Hz rTMS真刺激和伪刺激治疗;治疗前、后2组均行事件相关电位P300(P300)及威斯康星卡片分类测验(Wisconsin Card Sorting Test,WCST)检查。结果 (1)观察组治疗后P300中Fz、Cz点P3、NP3潜伏期缩短(P<0.05或P<0.01)、波幅升高(P<0.05或P<0.01),对照组P300各指标与治疗前比较差异无统计学意义(P>0.05);2组治疗后WCST中完成分类数、正确应答数、概念化水平应答百分比均较治疗前升高(P<0.05或P<0.01),错误应答数、持续性应答数、持续性错误数、完成第1个分类所需应答数较治疗前降低(P<0.05或P<0.01)。(2)治疗前2组P300及WCST各指标比较差异无统计学意义(P>0.05);治疗后观察组P300中Fz、Cz点P3、NP3潜伏期低于对照组(P<0.05),波幅高于对照组(P<0.05或P<0.01),WCST中完成分类数、正确应答数、概念化水平应答百分比均高于对照组(P<0.05或P<0.01),错误应答数、持续性应答数、持续性错误数、完成第1个分类所需应答数与对照组比较差异无统计学意义(P>0.05)。结论 10Hz rTMS可有效改善精神分裂症患者认知功能。

Objective To evaluate the effect of repetitive transcranial magnetic stimulation（rTMS）on cognitive function in patients with schizophrenia.Methods Seventy patients with schizophrenia were randomly divided into observation group（n=36）and control group（n=35）.Observation group received real rTMS and control group received sham rTMS for 4weeks besides the antipsychotic medication therapy with risperidone tablet.Both two groups underwent the eventrelated potential P300（P300）and Wisconsin Card Sorting Test（WCST）before and after treatment.Results Observation group showed shortened latency of P3 and NP3（Fz,Cz）in P300 after treatment（P〈0.05,P〈0.01）,and higher amplitude of P300（P〈0.05,P〈0.01）,and there was no significant difference in control group（P〉0.05）.The scores of completion of the classification numbers,correct responses numbers,and the percentage of conceptualization level response increased（P〈0.05,P〈0.01）,and the scores of error response numbers,sustained responses number,sustained numbers of error and the numbers of required response to complete the first category reduced（P〈0.05,P〈0.01）in WCST in both two groups.The indexes of P300 and WCST did not change significantly after treatment in both two groups（P〉0.05）.After treatment,the latencies of P3 and NP3（Fz,Cz）were lower,and the amplitude was higher in observation group than that in control group（P〈0.05,P〈0.01）.The scores of completion of the classification numbers,correct responses numbers,and the percentage of conceptualization level response were also higher in observation group than those in control group（P〈0.05,P〈0.01）,there were no significant differences in the scores of error response numbers,sustained responses number,sustained numbers of error,and the numbers of required response to complete the first category between two groups（P〉0.05）.Conclusion 10 Hz rTMS can effectively improve the cognitive function in schizophrenia patients.