文章摘要

重复经颅磁刺激对青少年抑郁症认知功能和血清脑源性神经营养因子水平的影响

作者: 1付影, 1王昆, 1陆振华, 2赵娟娟, 1童庆好
1 皖西卫生职业学院附属医院精神科,安徽 六安 237000
2 皖西卫生职业学院附属医院康复治疗室,安徽 六安 237000
通讯: 付影 Email: 464637905@qq.com
DOI: 10.3978/j.issn.2095-6959.2022.04.016

摘要

目的:探讨重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对青少年抑郁症(depressive disorder,DD)患者认知功能和血清脑源性神经营养因子(brain derived neurotrophic factor,BDNF)的影响。方法:选取2019年1月至2021年3月皖西卫生职业学院附属医院精神科收治的104例青少年DD患者,随机分成实验组与对照组,各52例。患者均接受常规药物治疗,实验组给予右侧背外侧前额叶(dorsolateral prefrontal cortex,DLPFC)低频rTMS治疗,对照组在相同刺激部位给予假刺激治疗,持续观察4周。比较两组汉密尔顿抑郁量表-24(Hamilton Depression Scale-24,HAMD-24)、蒙特利尔认知评估量表(Montreal Cognitive Assessment Scale,MoCA)、连线测试-A(Trail Making Test-A,TMT-A)、血清BDNF水平、抗抑郁疗效和不良反应情况。结果:两组治疗4周后,HAMD-24评分、TMT-A完成时间明显下降,MoCA评分、血清BDNF水平明显升高(均P<0.05);实验组治疗4周后,HAMD-24评分、TMT-A完成时间低于对照组,HAMD-24减分值、血清BDNF增加值和DD缓解率均高于对照组(均P<0.05)。治疗4周后,HAMD-24减分值与血清BDNF增加值呈正相关(r=0.549,P<0.05)。实验组出现3例轻微不良反应,适当休息后好转。结论:rTMS不仅能有效缓解青少年患者的DD症状,提高血清BNDF水平和DD缓解率,而且对改善认知功能也有积极作用。
关键词: 抑郁症;青少年;物理治疗;重复经颅磁刺激;认知功能;脑源性神经营养因子

Effects of repetitive transcranial magnetic stimulation on cognitive function and serum brain-derived neurotrophic factor levels in adolescents with depressive disorder

Authors: 1FU Ying, 1WANG Kun, 1LU Zhenhua, 2ZHAO Juanjuan, 1TONG Qinghao
1 Department of Psychiatric, Affiliated Hospital of West Anhui Health Vocational College, Lu’an Anhui 237000, China
2 Rehabilitation Treatment Room, Affiliated Hospital of West Anhui Health Vocational College, Lu’an Anhui 237000, China

CorrespondingAuthor: FU Ying Email: 464637905@qq.com

DOI: 10.3978/j.issn.2095-6959.2022.04.016

Abstract

Objective: To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive function and serum brain-derived neurotrophic factor (BDNF) in adolescents with depressive disorder (DD). Methods: A total of 104 adolescent DD patients treated in the psychiatric department of the Affiliated Hospital of Wanxi Health Vocational College from January 2019 to March 2021 were randomly divided into experimental group and control group, with 52 cases in each group. All patients received routine drug treatment. The experimental group was treated with low-frequency rTMS of the right dorsolateral prefrontal cortex (DLPFC), and the control group was treated with false stimulation at the same stimulation site, and the observation lasted for 4 weeks. Hamilton Depression Scale-24 (HAMD-24), Montreal Cognitive Assessment Scale (MoCA), connection test-a (TMT-A), serum BDNF level, antidepressant efficacy and adverse reactions were compared between the two groups. Results: After 4 weeks of treatment, HAMD-24 score and TMT-A completion time decreased significantly, and MoCA score and serum BDNF level increased significantly (all P<0.05). After 4 weeks of treatment, the score of HAMD-24 and the completion time of TMT-A in the experimental group were lower than those in the control group, and the reduced score of HAMD-24, the increased value of serum BDNF and the remission rate of DD in the experimental group were higher than those in the control group (all P<0.05). After 4 weeks of treatment, the reduced score of HAMD-24 was positively correlated with the increased value of serum BDNF (r=0.549, P<0.05). There were 3 cases of mild adverse reactions in the experimental group, which improved after appropriate rest. Conclusion: rTMS cannot only effectively alleviate DD symptoms, improve serum BNDF level and DD remission rate, but also improve cognitive function.
Keywords: depressive disorder; adolescents; physicotherapeutics; repetitive transcranial magnetic stimulation; cognitive function; brain-derived neurotrophic factor