摘要
目的探讨低频重复经颅磁刺激(low-frequency repetitive transcranial magnetic stimulation,LF-rTMS)作用于辅助运动前区(pre-supplementary motor area,pre-SMA)对强迫症(obsessive-compulsive disorder,OCD)患者的疗效。方法按照随机数字表法将100例强迫症患者分为pre-SMA组(33例)、背外侧前额叶(dorsolateral prefrontal cortex,DLPFC)组(32例)和对照组(35例),在原药物治疗基础上,pre-SMA组和DLPFC组分别于相应脑区给予1 Hz rTMS治疗,对照组给予假性刺激,分别在治疗前、治疗后第4周末和第12周末用耶鲁-布朗强迫量表(Yale-Brown obsessive compulsive scale,Y-BOCS)评估患者强迫症状。结果重复测量方差分析显示,Y-BOCS评分时间主效应、时间与组别交互作用有统计学意义(P<0.01)。治疗前比较3组总强迫评分差异无统计学意义(P>0.05);治疗4周末,DLPFC组强迫评分低于pre-SMA组、对照组(P<0.05);治疗12周末,pre-SMA组和DLPFC组强迫评分低于对照组(P<0.05)。pre-SMA组、DLPFC组、对照组强迫评分减分率(35.77%±10.51%vs.54.18%±10.09%vs.18.85%±6.52%)差异有统计学意义(F=110.38,P<0.01)。结论LF-rTMS刺激pre-SMA对改善强迫症患者症状具有临床意义。
Objective To explore the efficacy of low-frequency repetitive transcranial magnetic stimulation(LF-rTMS)over pre-supplementary motor area(pre-SMA)in obsessive-compulsive disorder(OCD)patients.Methods According to the method of random number table,100 patients were randomly divided into three groups:pre-SMA group(n=33),dorsolateral prefrontal cortex(DLPFC)group(n=32)and shame group(n=35).All groups were treated with different regions for 1 Hz rTMS therapy and all groups were treated for 12 weeks.Efficacy was assessed by the Yale-Brown obsessive compulsive scale(Y-BOCS)before and the 4th weekend and 12th weekend of the treatment.Results The repeated measures analysis revealed that there was significant effect of time and interactive effect of time×group in the scores of Y-BOCS were significant(P<0.01).At the 4th week,the DLPFC group was significantly lower than that of the pre-SMA group and the shame group(P<0.05).At the 12th week,the pre-SMA group and DLPFC group decreased significantly compared with the shame group(P<0.05).The reduction rate of Y-BOCS score was significantly different among pre-SMA group,DLPFC group and shame group(35.77%±10.51%vs.54.18%±10.09%vs.18.85%±6.52%,P<0.01).Conclusion LF-rTMS over pre-SMA has clinical significance in improving the OCD symptoms.
作者
王昕
张珊珊
孔焱
陈以琳
蒋常莲
叶兰仙
WANG Xin;ZHANG ShanShan;KONG Yan;CHEN Yilin;YE Lanxian(Department of psychiatry,Lanzhou University Second Hospital,Lanzhou 730030,China)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2020年第6期342-345,共4页
Chinese Journal of Nervous and Mental Diseases
基金
兰州大学硕导科研基金(编号:sdkyjj-18)。
