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高频重复经颅磁刺激(rTMS)可改善双相情感障碍的神经认知功能。

High-frequency repetitive transcranial magnetic stimulation (rTMS) improves neurocognitive function in bipolar disorder.

机构信息

Institute of Mental Health, Hebei Medical University, Shijiazhuang, 050031, China; Department of Psychiatry, First Hospital of Hebei Medical University, Shijiazhuang, 050031, China.

Department of Psychiatry, Eighth Hospital of Shijiazhuang, Shijiazhuang, 050080, China.

出版信息

J Affect Disord. 2019 Mar 1;246:851-856. doi: 10.1016/j.jad.2018.12.102. Epub 2018 Dec 25.

Abstract

BACKGROUND

Patients with bipolar disorder (BD) present widespread and significant neurocognitive impairments during all stages of the disorder. Repetitive transcranial magnetic stimulation (rTMS) has been used to improve clinical outcomes in common psychiatric diseases, such as depression, anxiety disorders, schizophrenia, and BD. Whether rTMS can improve cognitive function in BD patients remains unclear. The present study explored the regulatory effects of rTMS on cognitive function in patients with BD.

METHODS

Fifty-two eligible subjects with BD were randomly assigned to receive active or sham rTMS via high-speed magnetic stimulator with a figure-of-eight coil for 10 consecutive days. In the active rTMS group, a total of 25,000 stimuli were applied over the left dorsolateral prefrontal cortex at 110% of the motor threshold. The sham group received corresponding sham stimulation. Clinical manifestations and cognitive functions were assessed using a modified 24-item Hamilton Depression Rating Scale (HDRS), the Young Mania Rating Scale (YMRS), and the MATRICS Consensus Cognitive Battery (MCCB).

RESULTS

Ten consecutive days of high-frequency active rTMS improved scores on the Wechsler Memory Scale-III Spatial Span, and the MCCB Category Fluency subtest, without intolerable adverse effects. No significant differences in HDRS or YMRS scores were found between groups.

LIMITATIONS

No follow-up after the intervention. The effect of the drug on cognitive function in subjects was not excluded.

CONCLUSIONS

Short-term rTMS can improve cognitive function in BD patients.

摘要

背景

躁郁症(BD)患者在疾病的所有阶段都存在广泛而显著的神经认知障碍。重复经颅磁刺激(rTMS)已被用于改善常见精神疾病的临床结局,如抑郁症、焦虑障碍、精神分裂症和 BD。rTMS 是否可以改善 BD 患者的认知功能尚不清楚。本研究探讨了 rTMS 对 BD 患者认知功能的调节作用。

方法

52 名符合条件的 BD 患者被随机分配接受高频 rTMS 或假刺激,使用八边形线圈的高速磁刺激器,连续 10 天。在主动 rTMS 组中,在左背外侧前额叶皮层施加总共 25,000 次刺激,刺激强度为运动阈值的 110%。假刺激组接受相应的假刺激。使用改良的 24 项汉密尔顿抑郁评定量表(HDRS)、Young 躁狂评定量表(YMRS)和 MATRICS 共识认知电池(MCCB)评估临床症状和认知功能。

结果

10 天的高频主动 rTMS 可提高韦氏记忆量表-III 空间跨度和 MCCB 类别流畅性子测验的分数,且无不可耐受的不良反应。两组 HDRS 或 YMRS 评分无显著差异。

局限性

干预后无随访。未排除药物对受试者认知功能的影响。

结论

短期 rTMS 可改善 BD 患者的认知功能。

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