不同重复经颅磁刺激模式对精神分裂症认知功能和精神症状的影响被引量：64

Effects of repetitive transcranial magnetic stimulation with different paradigms on the cognitive function and psychotic symptoms of schizophrenia patients

下载PDF

导出

摘要目的:评价不同重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)模式对精神分裂症患者认知功能及精神症状的影响。方法:收集80例精神分裂症患者,并随机分配至4个rTMS干预组。4种rTMS干预模式分别是伪刺激、θ短阵快速脉冲刺激(theta burst stimulation,TBS)、10 Hz及20 Hz刺激,刺激部位均选择左侧前额叶背外侧皮质区(dorsolateral prefrontal cortex,DLPFC),刺激强度为80%运动阈值,每天的刺激总脉冲数均为1 200,连续刺激5 d。干预期间,原抗精神病药治疗方案不变。采用视空间工作记忆测试和词汇流畅性测试评估患者的认知功能,阳性症状与阴性症状量表(positive and negative symptom scale,PANSS)评估患者的精神症状。结果:20 Hz刺激可以改善患者的视空间工作记忆(t=-2.469,P=0.024),TBS刺激可以改善患者的词汇流畅性测试(t=-4.538,P=0.000),TBS刺激和10 Hz刺激均可以改善患者的阴性症状(TBS:t=5.373,P=0.000;10 Hz:t=2.272,P=0.036),10 Hz刺激和20 Hz刺激则可以改善患者的一般精神病理症状(10 Hz:t=2.725,P=0.014;20 Hz:t=3.632,P=0.002)。结论:rTMS对精神分裂症患者认知功能和精神症状的影响随刺激参数的改变而不同,提示rTMS为精神分裂症患者的个体化治疗提供了新途径。 Objective：To evaluate the effect of different paradigms of repetitive transcranial magnetic stimulation（rTMS） on the treatment of schizophrenia through assessing cognitive function and psychotic symptoms.Methods： Eighty patients diagnosed with schizophrenia were randomly assigned to four groups,which were sham intervention group,theta burst stimulation（TBS） group,10 Hz group and 20 Hz group.All the subjects were exposed to 5 daily treatments at 80% of motor threshold over the left dorsolateral prefrontal cortex with a total stimuli of 1 200 per day,while being maintained on their former antipsychotic treatment.Visual spatial working memory test and verbal fluency test were applied to evaluate the cognitive function,while Positive and Negative Symptom Scale（PANSS） was used to assess the psychotic symptoms.Results： 20 Hz of rTMS could improve the visual spatial working memory of schizophrenia patients（t=-2.469,P=0.024）.Only patients in TBS group showed significant improvement of verbal fluency test after rTMS treatment（t=-4.538,P=0.000）.The negative symptoms were alleviated significantly both in TBS and 10 Hz groups（TBS： t=5.373,P=0.000;10 Hz： t=2.272,P=0.036）.General psychopathology symptoms were improved significantly both in 10 Hz and 20 Hz groups（10 Hz：t=2.725,P=0.014;20 Hz：t=3.632,P=0.002）.Conclusion： The effects of rTMS on the cognitive function and psychotic symptoms of schizophrenia vary according to the changes in stimulus parameters,suggesting that rTMS could provide a new way for the individual therapy of schizophrenia.

作者郑丽娜郭茜李惠李春波王继军

机构地区上海交通大学医学院附属精神卫生中心

出处《北京大学学报（医学版）》 CAS CSCD 北大核心 2012年第5期732-736,共5页 Journal of Peking University:Health Sciences

基金上海市科学技术委员会基金(11410708800 11411966400) 国家自然科学基金(81171267)资助~~

关键词经颅磁刺激精神分裂症认知 Transcranial magnetic stimulation Schizophrenia Cognition

分类号 R749.3 [医药卫生—神经病学与精神病学]

引文网络
相关文献

参考文献16

1Conway ARA, Kane M J, Bunting MF, et al. Working memory span tasks : A methodological review and user' s guide [ J ]. Psy- chon Bull Rev, 2005, 12(5) : 769 -786.
2Wang K, Hoosain R, Li X, et al. Impaired recognition of fear in a Chinese man with bilateral cingulate and unilateral amygdala dam- age [J]. Cogn Neuropsychol, 2002, 19(7) : 641 -652.
3何燕玲,张明园.阳性和阴性症状量表的中国常模和因子分析[J].中国临床心理学杂志,2000,8(2):65-69. 被引量：309
4Schneider AL, Schneider TL, Stark H. Repetitive transcranial magnetic stimulation (rTMS) as an augmentation treatment for the negative symptoms of schizophrenia: a 4-week randomized placebo controlled study [J]. Brain Stimul, 2008, 1 (2) : 106 -111.
5Dlabae-de Lange JJ, Knegtering R, Aleman A. Repetitive tran- scranial magnetic stimulation for negative symptoms of schizophre- nia: review and meta-analysis [J]. J Clin Psychiatry, 2010, 71 (4) : 411 -418.
6Hajak G, Marienhagen J, Langgnth B, et al. High-frequency re- petitive transcranial magnetic stimulation in schizophrenia: a com- bined treatment and neuroimaging study [ J ]. Psychol Med, 2004, 34(7) : 1157 -1163.
7徐婉姣,金怡,黄悦勤,刘肇瑞,何华,陈进.脑电引导重复经颅磁刺激治疗精神分裂症的随机双盲对照实验[J].中国临床康复,2006,10(46):22-24. 被引量：23
8Huang YZ, Edwards MJ, Rounis E, et al. Theta burst stimulation of the human motor cortex [J]. Neuron, 2005,45(2) : 201 -206.
9Bor J, Brunelin J, Rivet A, et al. Effects of theta burst stimulation on glutamate levels in a patient with negative symptoms of schizo- phrenia [J]. Schizophr Res, 2009, 111(1 -3) : 196 -197.
10张志娟,张新凯,李惠,钟晓莲,成祖伟,廖力维,刘登堂,徐一峰,王继军.重复经颅磁刺激治疗精神分裂症阴性症状的随机双盲研究[J].上海精神医学,2010,22(5):262-265. 被引量：27

二级参考文献33

1彭晓哲,周晓林.情绪信息与注意偏向[J].心理科学进展,2005,13(4):488-496. 被引量：123
2徐婉姣,金怡,黄悦勤,刘肇瑞,何华,陈进.脑电引导重复经颅磁刺激治疗精神分裂症的随机双盲对照实验[J].中国临床康复,2006,10(46):22-24. 被引量：23
3郑晓华舒良等.状态－特质焦虑问卷在长春的测试报告[J].中国心理卫生杂志,1993,7(2):60-62.
4Kirkpatrick B.Editor's introduction:theme issue on negative symptoms.Schizophr Bull,2006,32:214-219.
5Barker AT,Jalinous R,Freeston IL.Non-invasive magnetic stimulation of human motor cortex.Lancet,1985,1(8437):1106-1107.
6Freitas C,Fregni F,Pascual-Leone A.Meta-analysis of the effects of repetitive transcranial magnetic stimulation (rTMS) on negative and positive symptoms in schizophrenia.Schizophr Res,2009,108(1-3):11-24.
7Huang YZ,Edwards MJ,Rounis E,et al.Theta burst stimulation of the human motor cortex.Neuron,2005,45:201-206.
8Mogg A,Purvis R,Eranti S,et al.Repetitive transcranial magnetic stimulation for negative symptoms of schizophrenia:a randomized controlled pilot study.Schizophr Res,2007,93(1-3):221-228.
9Potkin SG,Alva G,Fleming K,et al.A PET study of the pathophysiology of negative symptoms in schizophrenia.Am J Psychiatry,2002,159:227-237.
10Hajak G,Marienhagen J,Langguth B,et al.High-frequency repetitive transcranial magnetic stimulation in schizophrenia:a combined treatment and neuroimaging study.Psychol Med,2004,34(7):1157-1163.