Gupta Preeti, Sahu Anamika, Prasad Surjit, Sinha Vinod Kumar, Bakhla Ajay Kumar
Department of Clinical Psychology, Central Institute of Psychiatry, Ranchi, Jharkhand, India.
Student Wellness Centre, AIIMS, New Delhi, India.
Indian J Psychiatry. 2021 Jan-Feb;63(1):66-69. doi: 10.4103/psychiatry.IndianJPsychiatry_532_20. Epub 2021 Feb 15.
The use of repetitive transcranial magnetic stimulation (rTMS) in schizophrenia has shown improvement as well as deficits in memory. Though most studies had focused on dorsolateral prefrontal cortex only, but impact of rTMS on cognitive functions remain inconclusive. The need of the study is to assess the impact of rTMS on memory in schizophrenia.
Forty right-handed male patients with schizophrenia were included by purposive sampling and rated on Positive and Negative Syndrome Scale (PANSS) before starting the rTMS treatment with the experimental group. Low frequency 1 Hz rTMS including 1200 stimulations were given over temporo-parietal cortex for 20 min as add on to medications. At the end of 10 session treatment (5 days a week for 2 weeks), the patients were re-evaluated.
A total of 39 patients (20 for experimental group and 19 for control group) with mean age of 29.70 ± 9.05 and 31.26 ± 7.78 years, respectively, shows significant difference to pre- and post-treatment mean PANSS score in positive, negative and general psychopathology domains. The pre- and post-treatment mean Postgraduate Institute Memory Scale Scores with multivariate repeated measures analysis of variance revealed significant improvements in all memory domains ( < 0.01) except remote memory in both experimental and control groups.
RTMS in combination with antipsychotics has shown improvement in psychopathology in patients of schizophrenia without any deterioration of memory.
重复经颅磁刺激(rTMS)在精神分裂症治疗中的应用显示出记忆方面既有改善也有缺陷。尽管大多数研究仅关注背外侧前额叶皮层,但rTMS对认知功能的影响仍尚无定论。本研究旨在评估rTMS对精神分裂症患者记忆的影响。
通过目的抽样纳入40例右利手男性精神分裂症患者,在对实验组开始rTMS治疗前,使用阳性和阴性症状量表(PANSS)进行评分。在药物治疗基础上,对颞顶叶皮层给予低频1Hz的rTMS,共1200次刺激,持续20分钟。在10次治疗结束时(每周5天,共2周),对患者进行重新评估。
共有39例患者(实验组20例,对照组19例),平均年龄分别为29.70±9.05岁和31.26±7.78岁,在阳性、阴性和一般精神病理学领域的治疗前后平均PANSS评分显示出显著差异。通过多变量重复测量方差分析得出的治疗前后平均研究生学院记忆量表评分显示,除远期记忆外,实验组和对照组的所有记忆领域均有显著改善(<0.01)。
rTMS联合抗精神病药物可改善精神分裂症患者的精神病理学状况,且不会导致记忆恶化。