经颅微电流刺激治疗对阻抗性抑郁症患者自杀意念及关联性负变的影响

Effects of cranial electrotherapy stimulation on suicidal ideation and event-related potentials in patients with treatment-resistant depression

目的:探讨经颅微电流刺激治疗(CES)对治疗阻抗性抑郁症(TRD)患者自杀意念的影响,以及其神经电生理机制。方法:将67名TRD患者随机分为研究组和对照组,采用CES对研究组进行8周治疗。两组患者治疗前和治疗后分别进行Beck自杀意念量表中文版(BSICV)、汉密尔顿抑郁量表(HAMD)评估和事件相关电位关联性负变(CNV)检查。结果:CES治疗后,研究组自杀意念、HAMD得分下降(t=-2.0865,-2.1518;P<0.05),且自杀意念得分明显低于对照组(t=2.0315,P<0.05);CNV的M2波幅上升、PINV出现率减少(t=2.3513,P<0.05;χ^(2)=5.0708,P<0.05),且与对照组比较差异有统计学意义(t=-2.0252,P<0.05;χ^(2)=4.7308,P<0.05)。对照组治疗前后各项指标变化无统计学意义。结论:CES治疗能有效降低TRD患者的自杀意念,其对大脑信息加工过程的影响可能是缓解自杀意念的神经电生理机制之一。

Objective:To investigate the effect of cranial electrotherapy stimulation(CES)on suicidal ideation and its electrophysiological mechanism in patients with depression.Methods:A total of 67patients with treatment-resistant depression were randomly divided into study group and control group.The study group was treated with CES for 8 weeks.Before and after treatment,the patients in the two groups were assessed with Beck suicidal ideation scale(BSICV),Hamilton Depression Scale(HAMD)and event-related potentials-contingent negative change(CNV)respectively.Results:After CES treatment,the scores of BSICV and HAMD in the study group decreased(t=-2.0865,-2.1518;P<0.05),and the scores of suicide ideation in the study group was significantly lower than that in the control group(t=2.0315,P<0.05).After treatment,the M2amplitude of CNV increased and the incidence of PINV decreased in the study group(t=2.3513,P<0.05;χ^(2)=5.0708,P<0.05),and the difference was statistically significant compared with the control group(t=-2.0252,P<0.05;χ^(2)=4.7308,P<0.05).There was no statistical significance in the indexes of the control group before and after treatment(P>0.05).Conclusion:CES treatment can effectively reduce suicide ideation in TRD patients,and its effect on brain information processing may be one of the neuro-electrophysiological mechanisms to alleviate suicide ideation.