艾司西酞普兰联合rTMS对抑郁症患者P300、MMN的影响

Effects of Escitalopram Combined with rTMS on P300 and MMN in Depressed Patients

目的探究抑郁症患者艾司西酞普兰联合重复经颅磁刺激(rTMS)对相关电位P300与相关电位成分失匹配负波(MMN)的影响。方法应用随机数字表法将2022年2月至2023年12月于我院就诊的108例抑郁症患者分为两组,观察组(54例)及对照组(54例)。对照组应用艾司西酞普兰治疗,在其基础上观察组联合rTMS治疗。比较两组相关电位P300及MMN潜伏期、波幅、抑郁状态(HAMD-17)及认知功能(MoCA)评分;分析治疗前后P300及MMN潜伏期、波幅与HAMD-17的相关性。结果观察组治疗后的相关电位P300及MMN潜伏期均较对照组短,而波幅均较对照组高(P<0.05)。观察组治疗后的HAMD-17评分较对照组低,而MoCA评分较对照组高(P<0.05)。治疗前P300和MMN潜伏期、波幅与HAMD-17评分无相关性;治疗后,潜伏期P300及MMN与HAMD-17评分呈正相关(r=0.527、0.631),波幅P300及MMN与HAMD-17评分呈负相关(r=-0.624、-0.428)。结论抑郁症患者应用艾司西酞普兰联合rTMS治疗效果显著,有助于提升患者的认知功能,改善MMN及事项相关电位P300水平,同时还可有效缓解患者抑郁等不良情绪,对促进患者预后改善意义重大,值得临床应用。

Objective To investigate the effects of escitalopram combined with repetitive transcranial magnetic stimulation(rTMS)on correlation potential P300 and correlation potential component mismatched negative wave(MMN)in depressed patients.Methods A total of 108 cases of depression patients who visited our hospital from February 2022 to December 2023 were divided into two groups,the observation group(54 cases)and the control group(54 cases)by applying the random number table method.The control group was treated with escitalopram,and on its basis the observation group was treated with combined rTMS.Compare the related potentials P300 and MMN latency,wave amplitude,depression state(HAMD-17)and cognitive function(MoCA)scores of the two groups;analyze the correlation between P300 and MMN latency,wave amplitude and HAMD-17 before and after treatment.Results The correlation potentials P300 and MMN latency of the observation group after treatment were shorter than those of the control group,while the wave amplitudes were higher than those of the control group(P<0.05).The HAMD-17 score of the observation group after treatment was lower than that of the control group,while the MoCA score was higher than that of the control group(P<0.05).There was no correlation between P300 and MMN latency and wave amplitude and HAMD-17 scores before treatment;after treatment,latency P300 and MMN were positively correlated with HAMD-17 scores(r=0.527,0.631),and wave amplitude P300 and MMN were negatively correlated with HAMD-17 scores(r=-0.624,-0.428).Conclusions The application of escitalopram combined with rTMS treatment in patients with depression is effective,which helps to enhance the cognitive function of the patients,improve the MMN and matter-related potential P300 level,and also effectively alleviate the patients'depression and other adverse emotions,which is of great significance in promoting the improvement of the patients'prognosis,and is worthy of clinical application.