高频重复经颅磁刺激对老年抑郁症伴轻度认知功能损害患者的疗效

Effect of high-frequency repetitive transcranial magnetic stimulation on elderly patients with depression and mild cognitive impairment

目的探讨高频重复经颅磁刺激（rTMs）对伴有轻度认知功能损害的老年抑郁症患者的疗效。方法将48例伴有轻度认知损害的老年抑郁症患者随机分为对照组和试验组。对试验组患者进行为期4周、频率为20Hz的rTMS治疗。在治疗前、治疗后和治疗后3个月分别进行汉密尔顿抑郁量表（HAMD）、简易精神状态量表（MMSE），事件相关电位P300测试。结果治疗后，试验组HAMD评分低于对照组（t=-3．711，P=0．001），3个月后差异仍有统计学意义（t=-3．978，P〈0．01）。治疗后，试验组的MMSE评分高于对照组（t=2．705，P=0．010），3个月后差异仍有统计学意义t=2．934，P=0．006）。治疗后和治疗3个月后，和对照组相比，试验组Fz和Cz的P300波幅较大，差异有统计学意义（P〈0．01）。治疗后和治疗3个月后，试验组Fz和Cz的P300潜伏期短于对照组，差异均有统计学意义（P〈0．05）。结论rTMS治疗可同时改善伴轻度认知损害老年抑郁症患者的抑郁情绪和认知功能。

Objective To investigate the effect of high-frequency repetitive transcranial magnetic stimulation （rTMS） on elderly patients with depression and mild cognitive impairment. Methods Totals of elderly 48 patients with depression and mild cognitive impairment were randomly divided into control group and experimental group. Four weeks of 20 Hz rTMS was conducted in experimental group. Hamilton Depression Scale （HAMD）, Mini-mental State Examination （MMSE） and event-related potentials P300 were examed before treat- ment, after treatment and after 3 months. Results After treatment and after 3 months, HAMD scores of exper- imental group were significantly lower than that of control group （t=-3.711, P=0.001 ; t=-3.978, P 〈 0.01）, while MMSE scores were significantly higher than that of control group （t=2.705, P=0.01 ; t=2.934, P=0.006）. After treatment and after 3 months, amplitude of P300 on Fz and Cz was significantly larger （P 〈 0.01）, while latency of P300 was significantly shorter in experimental group than that of control group （P 〈 0.05）. Conclusions High frequency rTMS could improve depressive emotion and cognitive function in elderly patients with depression and mild cognitive impairment.