磁惊厥治疗与无抽搐电痉挛治疗抑郁发作的早期疗效及对认知功能的影响

目的 比较磁惊厥治疗(magnetic seizure therapy, MST)与无抽搐电休克治疗(modified electroconvulsive therapy, MECT)对抑郁发作早期的疗效及对认知功能的影响。方法 入组45例抑郁发作患者,分别接受MST和MECT治疗。采用汉密尔顿抑郁量表-17项(Hamilton Depression Scale-17 Item, HAMD-17),汉密尔顿焦虑量表(Hamilton Anxiety Scale, HAMA),临床总体印象量表(Clinical Global Impression Scale,CGI)进行临床症状评估,采用重复成套神经心理状态测验(the Repeatable Battery for the Assessment of Neuropsychological Status, RBANS)及简易智力状态检查量表(Mini-mental State Examination, MMSE)进行认知功能评估。评估时间点包括基线、治疗3次后、治疗6次后。结果 双因素重复测量方差分析显示,两组间治疗前后HAMD-17、HAMA、CGI-S、CGI-I评分差异均无统计学意义(P_组间>0.05),其中HAMD-17、HAMA、CGI-S评分均随治疗时间的延长逐渐降低(P_时间<0.05)。两组RBANS总分,均随治疗时间延长逐渐升高(P_时间<0.05);各时点,MST组RBANS总分高于MECT组,组间比较差异有统计学意义(P_组间<0.05),且随时间延长,MST的治疗效应组间增大(P_交互<0.05)。治疗3次和治疗6次后,HAMD减分率两组间比较差异无统计学意义。结论 MST治疗抑郁发作早期治疗疗效果与MECT相当,MST治疗6次后可改善患者的部分认知功能。

Comparison on the early efficacy and cognitive effect of magnetic seizure therapy and modified electroconvulsive therapy for depressive episodes

Objective To compare the early efficacy and effect on cognitive function of magnetic seizure therapy (MST) and modified electroconvulsive therapy (MECT) in the treatment of depressive episode. Methods A total of 45 patients with depression were treated with MST or MECT respectively. Hamilton Depression Scale-17 Item (HAMD-17), Hamilton Anxiety Scale (HAMA), and Clinical Global Impression Scale (CGI) was used to evaluate clinical symptoms. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Mini-mental State Examination (MMSE) were used to evaluate cognitive function. The evaluation time points included baseline, after 3 times and 6 times of treatment. Results Repeated measurement ANOVA showed that there was no significant difference in HAMD-17, HAMA, CGI-S and CGI-I scores between the two groups before and after treatment (P_group >0.05). HAMD-17, HAMA and CGI-S scores decreased along with the extension of treatment time (P_time<0.05). The total score of RBANS in both groups increased gradually with the extension of treatment time (P_time<0.05). At each time point, the total score of RBANS in MST group was higher than that in MECT group, with statistically significant difference between the groups (P_group<0.05), and the therapeutic effect of MST increased with time (P_time<0.05). After 3 and 6 times of treatment, there was no significant difference in HAMD score reduction rate between the two groups. Conclusion The early efficacy of MST was comparable to MECT in the treatment of depressive episode. MST improved the cognitive function of patients after 6 treatment times.