低频重复经颅磁刺激治疗帕金森病焦虑失眠的疗效分析

The Effect of Low Frequency Repetitive Transcranial Magnetic Stimulation on Anxiety and In⁃somnia in Patients with Parkinson’s Disease

目的:观察低频重复经颅磁刺激(rTMS)治疗帕金森病(PD)合并焦虑、失眠患者的疗效。方法:将PD合并焦虑、失眠患者64例随机分成观察组和对照组,每组32例。观察组在常规PD药物治疗基础上接受右侧前额叶背外侧区1 Hz的低频rTMS治疗;对照组接受常规PD药物治疗基础上接受右侧前额叶背外侧区假性磁刺激治疗;均治疗4周。比较治疗前、后2组患者的运动功能、焦虑状态及失眠情况的变化。结果:治疗前,2组的运动障碍疾病协会修订统一帕金森病评定量表(MDS-UPDRS-Ⅲ)评分、Hoehn-Yahr评分、焦虑自评量表(SAS)评分、匹兹堡睡眠质量指数(PSQI)评分差异无统计学意义(P>0.05)。治疗后,对照组的上述量表评分与治疗前差异无统计学意义(P>0.05);观察组的上述量表评分均低于同组治疗前,且低于对照组治疗后(均P<0.05)。结论:低频rTMS治疗可能有助于改善PD合并焦虑、失眠患者的运动功能和焦虑状态,提高其睡眠质量。

Objective:To evaluate the efficacy of low frequency-repetitive transcranial magnetic stimulation(rTMS)on anxiety and insomnia in patients with Parkinson’s disease(PD).Methods:64 patients with PD com-bined with anxiety and insomnia were enrolled and randomly divided into treatment group and control group,32 cases in each group.In addition to the conventional PD medication,patients in the treatment group received 1 Hz rTMS in the right dorsolateral prefrontal cortex(DLPFC),and patients in the control group received pseudo-mag-netic stimulation in the same area.All the patients were treated for four weeks.The changes of motor function,anxiety state and insomnia before and after treatment were compared between the two groups.Results:There were no significant differences in the motor function PD-UPDRS-Ⅲscore,Hoehn-Yahr score,anxiety SAS score,sleep PSQI score between the two groups before treatment(P>0.05).After treatment,the above scale scores in the control group were not significantly different from those before treatment(P>0.05).The above scale scores in the treatment group were lower than those in the same group before treatment,and were lower than those in the control group after treatment(P<0.05).Conclusion:Low-frequency rTMS may help to improve the motor function and anxiety state of patients with PD complicated with anxiety and insomnia,and improve their sleep quality.