fMRI引导下的重复经颅磁刺激治疗抑郁症的效果

Effect of fMRI-guided repeated transcranial magnetic stimulation for depression

目的:探讨功能磁共振(Functional Magnetic Resonance imaging,fMRI)引导下的重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗抑郁症的效果。方法:选取我院2020年6月至2022年11月期间收治的108例抑郁症患者,随机分为两组,常规组54例,给予传统5 cm定位下rTMS治疗,观察组54例,给予MRI引导下的rTMS治疗,观察两组临床疗效、抑郁程度、自杀意念以及认知功能。结果:观察组总有效率高于常规组(P<0.05);治疗4 w后,两组的贝克抑郁量表第2版中文版(Back Depression Inventory-Ⅱ,BDI-Ⅱ)BDI-Ⅱ评分均高于本组治疗前,且观察组的BDI-Ⅱ评分低于常规组(P<0.05);治疗4 w后,两组自杀意念自评量表(Self-rating Idea of Suicide Scale,SIOSS)各维度评分均低于本组治疗前,且观察组低于常规组(P<0.05);治疗4 w后,两组威斯康星卡片分类测试(Wsiconsin card sorting test,WCST)正确应答数均高于本组治疗前,且观察组高于常规组,持续性错误数均低于本组治疗前,且观察组低于常规组(P<0.05)。结论:MRI引导下的rTMS对抑郁症患者治疗效果显著,可有效缓解患者抑郁情绪,减轻自杀意念,改善认知功能。

Objective:To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)guided by Functional Magnetic Resonance Imaging(fMRI)in the treatment of depression.Methods:108 patients with depression admitted to our hospital from June 2020 to November 2022 were divided into two groups randomly:54 patients in the conventional group were given rTMS under traditional 5 cm positioning,and 54 patients in the observation group were given rTMS under fMRI guidance.The clinical efficacy,depression,suicidal ideation and cognitive function of the two groups were observed.Results:The total effective rate of the observation group was higher than that of the conventional group(P<0.05);After 4 weeks of treatment,the scores of the Back Depression Inventory-Ⅱ(BDI-Ⅱ)of the two groups were higher than those of the group before treatment,and the BDI-Ⅱscore of the observation group was lower than that of the conventional group(P<0.05);After 4 weeks of treatment,the scores of all dimensions of the Self rated Idea of Suicide Scale(SIOSS)in both groups were lower than those before treatment,and the observation group was significantly lower than that in the conventional group(P<0.05);After 4 weeks of treatment,the correct answer scores on the Wisconsin card sorting test(WCST)in both groups were higher than those before treatment,and WCST in the observation group was higher than that in the conventional group.The number of persistent errors was lower than before treatment in this group,and the observation group was lower than the conventional group(P<0.05).Conclusion:fMRI-guided rTMS is effective in the treatment of patients with depression,which can effectively relieve depressive mood,reduce suicidal ideation and improve cognitive function.