10 Hz 重复经颅磁刺激(rTMS)对慢性精神分裂症患者临床总体印象的影响。
Effects of 10 Hz repetitive transcranial magnetic stimulation (rTMS) on clinical global impression in chronic schizophrenia.
机构信息
Department of Psychiatry and Psychotherapy, Heinrich-Heine University of Düsseldorf, Bergische Landstr. 2, D-40629 Düsseldorf, Germany. joachim@
出版信息
Psychiatry Res. 2010 May 15;177(1-2):32-6. doi: 10.1016/j.psychres.2009.01.014. Epub 2010 Apr 8.
UNLABELLED
We conducted a randomized, sham-controlled repetitive transcranial magnetic stimulation (rTMS) study in chronic schizophrenia in-patients (n=35) to evaluate the therapeutic efficacy of 10 Hz stimulation. Patients, who were on stable antipsychotic treatment, were randomly assigned to the active or sham condition. In the active rTMS group, ten sessions with a total of 10,000 stimuli were applied over the left dorsolateral prefrontal cortex at 110% of motor threshold. The sham group received corresponding sham stimulation. Clinical improvement was measured by the Clinical Global Impression scale (primary outcome measure), the Global Assessment of Functioning Scale (GAF) and the Positive and Negative Symptom Scale (PANSS; secondary outcome measures). Between-group comparisons revealed no significant differences in clinical outcome variables. Only a subgroup of patients with pronounced negative symptoms developed some clinical improvement as indicated by significant changes in the GAF-scale. Besides there is some evidence for a more favourable clinical outcome within this subgroup after rTMS in the CGI-S and PANSS negative scale, too. In line with earlier investigations, our results suggest a moderate - potentially clinically relevant - treatment effect of prefrontal 10 Hz rTMS stimulation in chronic patients. However, in our study this beneficial effect was restricted to subjects with pronounced negative symptoms.
CLINICAL TRIAL REGISTRATION INFORMATION
ClinicalTrial.gov Identifier: NCT00169689, http://www.clinicaltrials.gov.
未加标注
我们对慢性精神分裂症住院患者(n=35)进行了一项随机、假刺激对照的重复经颅磁刺激(rTMS)研究,以评估 10Hz 刺激的治疗效果。接受稳定抗精神病药物治疗的患者被随机分配至真刺激或假刺激条件。在真刺激 rTMS 组中,在左背外侧前额叶皮层施加共 10,000 次刺激,强度为运动阈值的 110%。假刺激组接受相应的假刺激。临床改善情况通过临床总体印象量表(主要结局测量指标)、总体功能评估量表(GAF)和阳性与阴性症状量表(PANSS;次要结局测量指标)进行评估。组间比较显示,临床结局变量无显著差异。只有表现出明显阴性症状的患者亚组在 GAF 量表上出现显著变化,表现出一些临床改善。除此之外,在 CGI-S 和 PANSS 阴性量表中,rTMS 后这一组患者的临床结局也有更有利的迹象。与早期研究一致,我们的结果表明,前额叶 10Hz rTMS 刺激对慢性患者具有中等-潜在临床相关的治疗效果。然而,在我们的研究中,这种有益的效果仅限于表现出明显阴性症状的患者。
临床试验注册信息
ClinicalTrials.gov 标识符:NCT00169689,http://www.clinicaltrials.gov。