高频重复经颅磁刺激治疗老年卒中后抑郁的临床疗效

目的探讨高频重复经颅磁刺激(repetitive transcranial magnetic stimulation,r TMS)治疗老年卒中后抑郁(post-stroke depression,PSD)病人的临床疗效。方法选取我院2017年4月至2018年4月不伴有认知功能受损的老年PSD病人40例,随机分为r TMS组和对照组,每组20例。2组均给予脑卒中常规药物治疗及综合康复训练,在此基础上,r TMS组给予10 Hz高频r TMS治疗,对照组给予假刺激治疗。分别于治疗前及治疗第12周末采用病人健康问卷(PHQ-9)抑郁量表评定抑郁程度、改良Barthel指数(MBI)评定日常生活能力。结果治疗前,2组PHQ-9及MBI评分比较差异无统计学意义(P>0. 05);治疗第12周末,2组PHQ-9及MBI评分均较治疗前改善(P<0. 05),且r TMS组优于对照组(P<0. 05)。结论高频r TMS可改善老年PSD病人抑郁程度及日常生活能力。

Clinical efficacy of high-frequency repetitive transcranial magnetic stimulation in the elderly with post-stroke depression

Objective To investigate the clinical efficacy of high frequency repetitive transcranial magnetic stimulation(rTMS) in the elderly patients with post-stroke depression (PSD).Methods Forty elderly PSD patients without cognitive impairment in our hospital from April 2017 to April 2018 were selected and divided into the rTMS group and the control group randomly,with 20 cases in each group. Conventional drug treatment and comprehensive rehabilitation training for stroke were given in two groups, and on the basis of it,rTMS group was treated with 10 Hz high-frequency rTMS and the control group was treated with sham stimulation treatment respectively. The PHQ-9 for depression and the modified Barthel index (MBI) were used to evaluate the depression degree and daily life ability in two groups respectively before treatment and 12 weeks after treatment.Results There were no significant differences in scores of PHQ-9 and MBI between the two groups before treatment ( P > 0.05), at the end of the 12th week of treatment, the scores of PHQ-9 and MBI in two groups were improved ( P < 0.05),especially in rTMS group ( P < 0.05).Conclusions High frequency rTMS has a significant effect on improving PSD and daily living ability in the elderly after stroke.