低频重复经颅磁刺激辅助运动前区治疗强迫症的疗效分析
Efficacy of low frequency repetitive transcranial magnetic stimulation over presuppementary motor area in obsessive compulsive disorder

王昕张珊珊孔焱陈以琳蒋常莲叶兰仙 ^*

文摘	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1Hz 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。
其他语种文摘	Objective To explore the efficacy of low-frequency repetitive transcranial magnetic stimulation (LFrTMS) 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.
来源	中国神经精神疾病杂志 ,2020,46(6):342-345 【核心库】
DOI	10.3969/j.issn.1002-0152.2020.06.005
关键词	重复经颅磁刺激 ; 强迫症 ; 辅助运动前区
地址	兰州大学第二医院心理卫生科, 兰州, 730030
语种	中文
文献类型	研究性论文
ISSN	1002-0152
学科	神经病学与精神病学
基金	兰州大学硕导科研基金
文献收藏号	CSCD:6795074