中国全科医学2017，Vol.20Issue(25)：3171-3177,7.DOI:10.3969/j.issn.1007-9572.2017.25.023
重复经颅磁刺激对慢性精神分裂症患者认知功能和血清脑源性神经营养因子水平的影响研究
Effect of rTMS on the Cognitive Function and sBDNF Levels in Chronic Schizophrenia Patients
摘要
Abstract
Objective To evaluate the effect of repetitive transcranial magnetic stimulation (rTMS) with 5 Hz or 10 Hz on the cognitive function and serum brain-derived neurotrophic factor (sBDNF) levels in chronic schizophrenia.Methods According to the random number table,90 patients with chronic schizophrenia receiving inpatient treatment in Wuxi Mental Health Center Affiliated to Nanjing Medical University from February 2014 to June 2016 were equally divided into three groups:group A,group B and group C.The rTMS treatment for all the groups consists of two stages.For group A,in the first stage,they received 10 times of rTMS treatment with a frequency of 5 Hz,after that,they received 10 times of rTMS treatment with a frequency of 10 Hz after one-week break.For group B,they first received 10 times of rTMS treatment with a frequency of 10 Hz,and after one week of break,they received 10 times of rTMS treatment with a frequency of 5 Hz.For group C,they received 10 times of sham rTMS treatment with a frequency of 5 Hz,and 10 times of sham rTMS treatment with a frequency of 10 Hz subsequently after a one-week interval.The severity of mental illness was assessed by Positive and Negative Syndrome Scale (PANSS) and cognitive function was assessed by the Chinese Cognitive Ability Scale (CCAS) on the preceding day of rTMS treatment,and on the day completing the rTMS treatment or first day after the rTMS treatment,respcctively.sBDNF was measured on the preceding day of rTMS treatment,and on the first day after rTMS treatment,respectively.Results Before rTMS treatment,three groups presented similar total scores of PANSS and CCAS and the scores of each subscale of the two and sBDNF levels (P ＞ 0.05).After treatment,the total scores of PANSS and scores of Negative Scale,the total scores of CCAS and scores of the digit span,Chinese word matching,picture and word matching quiz,scores of learning ability dimension,verbal IQ and the overall scores of IQ and sBDNF levels differed significantly between all the groups (P ＜ 0.05),in particular,group C had higher total scores of PANSS and scores of Negative Scale,lower scores of digit span,Chinese word matching,picture and word matching quiz,learning ability dimension,verbal IQ and lower total scores of IQ and lower sBDNF levels than the other two groups (P ＜ 0.05).The results of Pearson correlation analysis showed,the treatment-derived difference in Positive Scale scores was negatively correlated with that of CCAS reasoning ability dimension scores (P ＜ 0.05);the treatment-derived difference in total scores of PANSS as well as in Negative Scale scores had negative correlations with that in scores of CCAS working memory,learning ability,reasoning ability,spatial computation,processing speed dimensions,and verbal IQ and operation IQ and total scores of IQ (P ＜ 0.05);the treatment-derived difference in sBDNF levels was positively correlated with that in scores of CCAS working memory,learning ability,reasoning ability,spatial computation,processing speed dimensions,and verbal IQ and operation IQ (P ＜ 0.05).The three groups demonstrated similar incidence of adverse reactions during the treatment (P ＞0.05).Conclusion Both the patterns of rTMS treatment used in groups A and B can improve the cognitive function in patients w ith chronic schizophrenia,which may be achieved by improving the negative symptoms and increasing the sBDNF levels.关键词
精神分裂症/经颅磁刺激/认知/脑源性神经营养因子Key words
Schizophrenia/Transcranial magnetic stimulation/Cognition/Brain-derived neurotrophic factor分类
医药卫生引用本文复制引用
徐清,过苑,程灶火,刘晓伟,张玉琦,顾君,董爱国,邓兆安,袁建明,俞水..重复经颅磁刺激对慢性精神分裂症患者认知功能和血清脑源性神经营养因子水平的影响研究[J].中国全科医学,2017,20(25):3171-3177,7.基金项目
无锡市医院管理中心医学科研项目(YGZXQ1307) （YGZXQ1307）
南京医科大学科技发展面上基金项目(2013NJMU206) （2013NJMU206）
