双额与单侧顶颞无抽搐电痉挛治疗对精神分裂症患者认知功能的影响

The Effect of Bifrontal and Unilateral Parieto-temporal Modified Electroconvulsive Therapy on Cognitive Function of Patients with Schizophrenia

目的比较双额极与单侧顶颞极无抽搐电痉挛治疗对精神分裂症认知功能的影响。方法将58例精神分裂症患者随机分为两组,其中双侧组28例,单侧组30例。一组接受双额极(双侧组)无抽搐电痉挛治疗,另一组接受非优势半球单侧顶颞极(单侧组)无抽搐电痉挛治疗。共给予无抽搐电痉挛治疗8次,应用重复性成套神经心理状态测验手册在治疗前、治疗4次、6次、8次时进行认知功能检测。结果治疗4次时,单侧组和双侧组RBANS总分和治疗前相比均明显降低,差异有显著统计学意义(单侧:t=3.398,P=0.002;双侧:t=4.459,P=0.000),两组间相比无差异。治疗8次时,单侧组和双侧组RBANS总分和治疗前相比增高,单侧组差异有显著统计学意义(t=-3.223,P<0.01),双侧组差异无统计学意义;在对视觉空间的影响上,单侧组评分增高,双侧组评分降低,两组之间差异有统计学意义(F=-3.43,P=0.03)。结论 MECT对认知功能的影响与电极安放位置和治疗次数等参数有关,对认知功能的不同成分有不同的影响。

Objective To compare the effects of bifrontal and unilateral parieto -temporal MECT on cognitive function of patients with schizophrenia .Methods 58 patients with schizophrenia were randomly divided into two groups ,one group received bifrontal MECT （bifrontal groups,28 cases）,another group received unilateral parieto -temporal MECT（unilateral group,30 cases）.Repeatable Battery for the assessment of Neuropsychological Status （RBANS）was used to evaluate cognitive function before treatment ,4 times point,6 times point,8 times point.Results At 4 times point,RBANS score significantly decreased compared with pre treatment in both group （ P〈0.01）.At 8 times point,RBANS total scores increased in both group,but there was significant difference（P〈0.01）only in unilateral group.Conclusion The effect of MECT on cognitive function varies accorording to electrode placement and times of treatment ,treatment parameters .