rTMS与利培酮治疗阿尔茨海默病患者精神行为症状的疗效观察

rTMS vs Risperidone in the Treatment of BPSD of Alzheimer's Disease

目的:观察重复经颅磁刺激(r TMS)和利培酮对阿尔茨海默病患者精神行为症状(BPSD)的临床疗效。方法:将45例患有阿尔茨海默病且伴有BPSD的患者随机分为研究组(20例)和对照组(25例),研究组患者接受20次5HZ r TMS,对照组接受利培酮治疗,两组治疗期间维持原有的胆碱酯酶抑制剂。治疗前及治疗2周和6周后进行神经精神科问卷(Neuropsychiatric Inventory,NPI)和简明精神状态检查(MMSE)等评分观察疗效。结果:45例患者完成治疗,治疗6周后两组NPI得分均有降低,组内治疗前后比较,差异达统计学意义(t=12.18,2.29;P<0.05);两组间评分比较无显著性差异(t=0.68,0.42,0.66;P>0.05);两组的MMSE评分有所上升,治疗6周后两组内前后比较,差异有统计学意义(t=2.45,2.92;P<0.05)两组间评分无显著性差异(t=0.17,0.92,0.26;P>0.05)。结论:重复经颅磁刺激可能是控制轻中度阿尔茨海默病患者BPSD的一种有效而安全的治疗方法。

Objective： To explore the effects of repetitive Transcranial Magnetic Stimulation（ rTMS）in treatment of behavioral and psychological symptoms of dementia（ BPSD） of patients with mild- to-moderate Alzheimer ＇s disease（ AD）. Methods： 45 mild- to moderate AD patients accompanied with BPSD were randomly divided to active r TMS group（ 20 cases） and Risperidone group（ 25 cases）. Subjects of r TMS group were treated with r TMS respectively for 20 times during 6 weeks,and the subjects of Risperidone group were treated with risperidone,all patients were received with stable cholinesterase inhibitors. Neuropsychiatric Inventory（ NPI） and Mini- Mental Status Examination（ MMSE） were assessed before treatment and 2 weeks and 6 weeks after treatment. Results： 45 subjects completed the trial.The NPI improved significantly after 6 weeks of active treatment. There was no statistical significance in TESS between two groups. Conclusion： In this study,r TMS seems a promising effective and safe therapies for BPSD of mild- to- moderate AD.