高频重复经颅磁刺激对慢性精神分裂症患者认知功能的影响

目的：探讨高频重复经颅磁刺激（rTMS ）对慢性精神分裂症患者认知功能的影响。方法本研究为随机假刺激对照双盲随访临床试验。47例以阴性症状为主的慢性精神分裂症患者按随机数字表分为研究组（n ＝25）和对照组（n ＝22），分别给予每周5次持续4周的10 Hz 110％ M T 的rTMS 真刺激和假刺激治疗；在基线期、4周末、8周末用阴性症状量表（SANS）、图形识别记忆（PRM ）分别评定患者阴性症状与认知功能，采用治疗不良反应量表（TESS）评估不良反应。结果研究组经治疗后 SANS 总分及各因子分均较基线时下降，而对照组仅 SANS 总分、情感平淡因子分及注意障碍因子分较基线时下降，差异有统计学意义（P ＜0．05）；且第8周末研究组 SANS 总分及除情感平淡因子分以外的其他因子分较第4周末相比下降，差异均有统计学意义（P ＜0．05）。研究组在治疗8周末时正确题数明显提高，选择时间和间隔时间同时明显缩短，组间不同时间点比较差异有统计学意义（P ＜0.05），而对照组各时间点比较差异均无统计学意义（P ＞0．05）。结论 rTMS 辅助治疗可以改善慢性精神分裂症患者的认知功能，且效应延迟出现。

Efficacy of high - frequency repetitive transcranial magnetic stimulation(rTMS) on cognitive function in pa-tients with chronic schizophrenia

Objective To observe the efficacy of high - frequency repetitive transcranial magnetic stimulation (rTMS) on cognitive function in patients with chronic schizophrenia .Methods This was a randomized ,sham - controlled ,double - blinded trial .Forty - seven patients diagnosed with chronic schizophrenia were randomly assigned to study group (n = 25) and control group (n = 22) .Patients in study group were received 10 Hz 110% M T rTMS ,while patients in control group were subjected to sham rTMS ,both being given 4 - week treatment (5 days per week) .Negative symptoms and cognitive function were assessed by Negative Symdrome Scale(SANS) and Pattern Recognition Memory(PRM ) at baseline ,at the end of 4 ,8 weeks .Treatment Emergent Symptom Scale(TESS) was used to evaluated side effects .Results Compared with baseline ,SANS total score and each factor score were decreased af-ter treatment in the study group ,while the control group ,only SANS total score ,emotional insipid fac-tor score and attention disorder factor score were decreased ,the differences were all statistically signifi-cant (P < 0 .05) .At the end of 8 weeks ,SANS score and other factors in addition to emotional insipid factor score were lower than at the end of 8 weeks in the study group ,the differences were statistically significant (P < 0 .05) .Patients in the study group in the treatment of 8 weeks ,right number of ques-tions increased significantly ,while choosing time and interval time shortened obviously at the same time , the difference between groups was statistically significant (P < 0 .05) ,and the differences between each time point had no statistical significance (P > 0 .05) .Conclusions rTMS adjuvant therapy can improve cognitive function in patients with chronic schizophrenia ,and the efficacy is delayed .