高频重复经颅磁刺激对帕金森病患者抑郁、焦虑及生活质量的疗效观察

Effectiveness of high-frequency repetitive transcranial magnetic stimulation on the depression,anxiety and quality of life of Parkinson disease patients

目的探讨高频重复经颅磁刺激(rTMS)对帕金森病(PD)患者抑郁、焦虑及生活质量的影响。方法选取2019年10月—2022年6月徐州仁慈医院收治的58例帕金森病合并抑郁、焦虑状态的患者。按照随机数字表1∶1分配到rTMS治疗组(高频5 Hz+常规抗PD药物)和对照组(抗抑郁焦虑药物+常规抗PD药物),比较治疗前和治疗14 d、30 d随访、90 d随访时患者抑郁和焦虑情况、Hoehn-Yahn(H-Y)分期以及生活质量评分。结果治疗14 d、30 d随访时,2组汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)以及PDQ-39评分低于治疗前,且rTMS治疗组低于对照组,差异有统计学意义(P<0.05)。90 d随访时,2组HAMD、PDQ-39评分低于治疗前,差异有统计学意义(P<0.05)。治疗前、治疗14 d、30 d随访、90 d随访,2组H-Y分期差异无统计学意义(P>0.05)。结论rTMS可显著改善帕金森病患者抑郁、焦虑症状和生活质量,且安全性高。

Objective To investigate the effects of high-frequency repetitive transcranial magnetic stimulation(rTMS)on the depression,anxiety and quality of life of Parkinson disease patients.Methods A total of 58 patients with Parkinson disease who were admitted to Xuzhou Renci Hospital from October 2019 to June 2022 were enrolled.According to the random number table method,they were divided into two groups in a ratio of 1∶1:a rTMS treatment group(high-frequency 5 Hz+conventional anti-PD agents)and a control group(antidepressants and anxiety agents+conventional anti-PD agents).Both groups were compared for depression,anxiety,Hoehn Yahn(H-Y)staging and quality of life scores before treatment,and postoperative 14,30 and 90 days.Results At postoperative 14 and 30 days,both groups presented lower scores of HAMD,HAMA and PDQ-39 before those before treatment,where the rTMS treatment group was remarkably lower than the control group(P<0.05).After follow-up visit at postoperative 90 days,both groups showed lower scores of HAMD and PDQ-39 than those before treatment(P<0.05).There was no statistical difference in H-Y staging between the two groups before treatment and at postoperative 14,30 and 90 days(P>0.05).Conclusions rTMS can significantly improve the depression,anxiety and quality of life of patients with Parkinson disease,with good safety.