阿戈美拉汀联合rTMS对首发抑郁症认知功能的影响
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摘要
目的探讨阿戈美拉汀联合rTMS治疗首发抑郁症的疗效及认知功能的影响。方法将90例首发抑郁症患者用EpiCalc 2000随机分为两组,各45例,在阿戈美拉汀治疗基础上,研究组给予rTMS治疗,对照组给予伪刺激治疗。分别于治疗第0、1、2、4周末采用汉密尔顿抑郁量表(HAMD-17)评定疗效、用韦氏智力测验(WAIS)中数字符号、数字广度、韦氏记忆量表(WMS)、威斯康星卡片分类测验(WCST)、连线测验(TMT)、词语流畅性测验(VFT)评定认知功能。结果在治疗后第1、2、4周末研究组HAMD评分明显低于对照组;4周末研究组有效率高于对照组;4周末研究组WCST非持续错误数、VFT重复数较治疗前减少,对照组TMT-A提笔次数较治疗前减少。与对照组比较,研究组治疗后第4周末WCST持续错误数、TMT连线时间较少,VFT总数较高,以上均有统计学差异(P<0.05)。结论 rTMS联合阿戈美拉汀治疗首发抑郁症安全、快速、有效,并改善认知功能。
Objective To investigate the effect of agomelatine combined with rTMS in the treatment of initial depression and its effect on the cognitive impairment of patients. Methods Ninety patients with first-episode depression were randomly divided into two groups by EpiCalc 2000. On the basis of the treatment of agomelatine,the study group was given rTMS treatment,and the control group was given pseudo-stimulation treatment. They respectively receive treatment and were assessed the efficacy at the end of the 0,1 st,2 nd,and 4 th week with Hamilton Depression Rating Scale(HAMD-17),the WAIS number sign,number breadth,Webster's Memory Scale(WMS),Wisconsin Card Sorting Test(WCST),TMT and VFT to assess the cognitive function. Results HAMD scores in the study group were significantly lower than those in the control group on the 1 st,2 nd,and 4 th week after treatment. The effective rate of the study group was higher than that of the control group on the 4 th weekend. The number of WCST non-sustained errors and VFT repetitions were lower in the study group on the 4 th weekend than before treatment. The number of TMT-A pens in the control group was lower than before treatment. Compared with the control group,the number of WCST persistent errors,TMT connection time,and the total number of VFTs were higher in the study group at the 4 th week after treatment(P<0.05). Conclusion rTMS combined with agomelatine can improve the effect of antidepressant effect,enhance anti-depression effect,and improve cognitive impairment.
Objective To investigate the effect of agomelatine combined with rTMS in the treatment of initial depression and its effect on the cognitive impairment of patients. Methods Ninety patients with first-episode depression were randomly divided into two groups by EpiCalc 2000. On the basis of the treatment of agomelatine,the study group was given rTMS treatment,and the control group was given pseudo-stimulation treatment. They respectively receive treatment and were assessed the efficacy at the end of the 0,1 st,2 nd,and 4 th week with Hamilton Depression Rating Scale(HAMD-17),the WAIS number sign,number breadth,Webster's Memory Scale(WMS),Wisconsin Card Sorting Test(WCST),TMT and VFT to assess the cognitive function. Results HAMD scores in the study group were significantly lower than those in the control group on the 1 st,2 nd,and 4 th week after treatment. The effective rate of the study group was higher than that of the control group on the 4 th weekend. The number of WCST non-sustained errors and VFT repetitions were lower in the study group on the 4 th weekend than before treatment. The number of TMT-A pens in the control group was lower than before treatment. Compared with the control group,the number of WCST persistent errors,TMT connection time,and the total number of VFTs were higher in the study group at the 4 th week after treatment(P<0.05). Conclusion rTMS combined with agomelatine can improve the effect of antidepressant effect,enhance anti-depression effect,and improve cognitive impairment.
引文
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7.马元业,李刚,周东林,等,低频重复经颅磁刺激治疗首发抑郁症患者的临床疗效观察[J].国际精神病学杂志,2015,(02):21-24.
8.Carney RM,Shelton RC.Agomelatine for the treatment of major depressive disorder[J].Expert Opin Pharmacother,2011,12(15):2411-2419.
9.张传波,葛茂宏,张玉芹,等,重复经颅磁刺激治疗首发抑郁症快速起效作用的临床研究[J].精神医学杂志,2013,(01):50-51.
10.O’Connor MG,Jerskey BA,Robertson EM,et al.The effects of repetitive transcranial magnetic stimulation(rTMS)on procedural memory and dysphoric mood in patients with major depressive disorder[J].Cogn Behav Neurol.2005,18(4):223-227.
11.Kuroda Y,Motohashi N,Ito H,et al.Effects of repetitive transcranial magnetic stimulation on[11C]raclopride binding and cognitive impairment in patients with depression[J].J Affect Disord.2006,95(1-3):35-42.
12.张烨,黄国平,李烨,等.重复超低频经颅磁刺激对首发抑郁症患者的早期疗效及认知功能影响的初步分析[J].四川精神卫生,2013,(01):38-41.
13.Nadeau SE,Bowers D,Jones TL,et al.Cognitive effects of treatment of depression with repetitive transcranial magnetic stimulation[J].Cogn Behav Neurol.2014,27(2):77-87.
14.Bagherzadeh Y,Khorrami A,Zarrindast MR,et al.Repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex enhances working memory[J].Exp Brain Res.2016,234(7):1807-1818.
2.Blier P,Ward HE,Tremblay P,et al.Combination of antidepressant medications from treatment initiation for major depressivedisorder:a double-blind randomized study[J].Am J Psychiatry,2010,167(3):281-288.
3.Concerto C,Lanza G,Cantone M,et al.Repetitive transcranial magnetic stimulation in patients with drug-resistant major depression:A six-month clinical follow-up study[J].Int J Psychiatry Clin Pract.2015,19(4):252-258.
4.Wu WM,Zou SH.Probe into Correlation between Impulsive Aggressive Behavior and Cognitive Impairment in Patients with Bipolar Disorders[J].Journal of Psychiatry and Brain Science,2016,1(4):4.
5.杨栋,谌益华,彭红莉,等.重复经颅磁刺激治疗首发抑郁症疗效和认知功能研究[J].精神医学杂志,2017,(01):56-58.
6.栾晓英.重复超低频经颅磁刺激联合抗抑郁药物对抑郁症患者早期疗效的影响[J].精神医学杂志,2016,(06):434-436.
7.马元业,李刚,周东林,等,低频重复经颅磁刺激治疗首发抑郁症患者的临床疗效观察[J].国际精神病学杂志,2015,(02):21-24.
8.Carney RM,Shelton RC.Agomelatine for the treatment of major depressive disorder[J].Expert Opin Pharmacother,2011,12(15):2411-2419.
9.张传波,葛茂宏,张玉芹,等,重复经颅磁刺激治疗首发抑郁症快速起效作用的临床研究[J].精神医学杂志,2013,(01):50-51.
10.O’Connor MG,Jerskey BA,Robertson EM,et al.The effects of repetitive transcranial magnetic stimulation(rTMS)on procedural memory and dysphoric mood in patients with major depressive disorder[J].Cogn Behav Neurol.2005,18(4):223-227.
11.Kuroda Y,Motohashi N,Ito H,et al.Effects of repetitive transcranial magnetic stimulation on[11C]raclopride binding and cognitive impairment in patients with depression[J].J Affect Disord.2006,95(1-3):35-42.
12.张烨,黄国平,李烨,等.重复超低频经颅磁刺激对首发抑郁症患者的早期疗效及认知功能影响的初步分析[J].四川精神卫生,2013,(01):38-41.
13.Nadeau SE,Bowers D,Jones TL,et al.Cognitive effects of treatment of depression with repetitive transcranial magnetic stimulation[J].Cogn Behav Neurol.2014,27(2):77-87.
14.Bagherzadeh Y,Khorrami A,Zarrindast MR,et al.Repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex enhances working memory[J].Exp Brain Res.2016,234(7):1807-1818.