高精度经颅直流电刺激对精神分裂症患者认知及社会功能的影响

Effects of high definition transcranial direct current stimulation on cognitive and social functions in convalescent schizophrenics

目的探讨高精度经颅直流电刺激(HD-tDCS)对恢复期精神分裂症患者认知及社会功能的影响。方法招募医院收治的恢复期精神分裂症患者100例,随机分为真刺激组和假刺激组,每组各50例,两组均在精神科药物治疗基础上采用HD-tDCS刺激患者左侧背外侧前额叶。真刺激组采用1.5 mA的电流刺激20 min,假刺激组仅在刺激开始与结束的30 s内有电流通过,每天1次,持续进行10 d。在治疗前后分别采用住院精神病患者社会功能评定量表(SSPI)、中文版MATRICS认知成套测验(MCCB)对两组患者的社会功能与认知功能进行测评,并比较两组在HD-tDCS治疗过程中出现的不良反应。结果治疗前两组SSPI及MCCB总分与各项评分比较,差异均无统计学意义(P>0.05);治疗后两组患者SSPI总分及各项因子分均较治疗前升高(P<0.05),且真刺激组的SSPI总分及各项因子分高于假刺激组(P<0.05);治疗后真刺激组MCCB总分、信息处理速度、注意/警觉、工作记忆、推理和问题解决单项分均较治疗前升高(P<0.05),假刺激组仅MCCB总分与推理和问题解决单项分较治疗前升高(P<0.05);治疗后真刺激组的MCCB总分及4个因子分(信息处理速度、注意/警觉、工作记忆、推理和问题解决)高于假刺激组(P<0.05)。两组患者均对电刺激或者假刺激耐受良好,未出现严重不良事件,且两组疼痛感、痒感、皮肤发红等不良反应比较,差异均无统计学意义(P>0.05)。结论对于恢复期精神分裂症患者采用HD-tDCS治疗,有利于促进患者认知功能康复,并进一步提高社会功能,且安全性高,有着良好的应用前景。

Objective To investigate the effect of high-precision transcranial direct current stimulation(HD-tDCS)on cognitive and social functions in convalescent schizophrenics.Methods 100 cases of convalescent schizophrenics admitted to our hospital from January 2018 to June 2019 were selected as the research objects.According to the random number table method,they were divided into two groups,and 50 cases in each group.Both groups used HD-tDCS to stimulate the left dorsolateral prefrontal lobe on the basis of conventional psychiatric treatment.The real stimulation group used 1.5 mA current stimulation for 20 min,and the false stimulation group only used 30 s passing at the beginning and end of stimulation,both once a day,lasting for 10 days.The social function and cognitive function of the two groups were assessed by the inpatient psychiatric social function assessment scale(SSPI)and the Chinese version of the matrix cognitive battery(MCCB)before and end of the treatment,and the adverse reactions of the two groups in HD-tDCS treatment were compared.Results There was no significant difference in the total score of SSPI and MCCB between the two groups before and after treatment(P>0.05);After treatment,the total score of SSPI and all factors in the two groups were higher than those before treatment(P<0.05),and the total score of SSPI and all factors in the real stimulation group were higher than those in the false stimulation group(P<0.05);After treatment,the total score of MCCB,information processing speed,attention/alarm in the real stimulation group were higher than those in the real stimulation group(P<0.05)The scores of perception,working memory,reasoning and problem solving were higher than those before treatment(P<0.05).The patients in both groups were well tolerated to electrical stimulation or false stimulation,and there was no serious adverse event and no significant difference between the two groups(P<0.05).Conclusion HD-tDCS treatment for convalescent schizophrenics is beneficial to promote cognitive rehabilitation and further improve social function,which has a good application prospect.