Liu Jin-Ling, Tan Zhi-Mei, Jiao Shu-Jie
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China.
Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China.
World J Psychiatry. 2023 Jul 19;13(7):453-460. doi: 10.5498/wjp.v13.i7.453.
Treatment-refractory schizophrenia (TRS), accounting for approximately 30% of all schizophrenia cases, has poor treatment response and prognosis despite treatment with antipsychotic drugs.
To analyze the therapeutic effectiveness of repetitive transcranial magnetic stimulation (rTMS) combined with olanzapine (OLZ) and amisulpride (AMI) for TRS and its influence on the patient's cognitive function.
This study enrolled 114 TRS patients who received treatment at the First Affiliated Hospital of Zhengzhou University between July 2019 and July 2022. In addition to the basic OLZ + AMI therapy, 54 cases of the control group (Con group) received modified electroconvulsive therapy, while 60 cases of the research group (Res group) received rTMS. Data on therapeutic effectiveness, safety (incidence of drowsiness, headache, nausea, vomiting, or memory impairment), Positive and Negative Symptom Scale, Montreal Cognitive Assessment Scale, and Schizophrenia Quality of Life Scale were collected from both cohorts for comparative analyses.
The Res group elicited a higher overall response rate and better safety profile when compared with the Con group. Additionally, a significant reduction was observed in the post-treatment Positive and Negative Symptom Scale and Schizophrenia Quality of Life Scale scores of the Res group, presenting lower scores than those of the Con group. Furthermore, a significant increase in the Montreal Cognitive Assessment Scale score was reported in the Res group, with higher scores than those of the Con group.
The treatment of TRS with rTMS and OLZ + AMI is effective and safe. Moreover, it can alleviate the patients' mental symptoms, improve their cognitive function and quality of life, and has a high clinical application value.
难治性精神分裂症（TRS）约占所有精神分裂症病例的30%，尽管使用抗精神病药物治疗，但其治疗反应和预后较差。
分析重复经颅磁刺激（rTMS）联合奥氮平（OLZ）和阿立哌唑（AMI）治疗TRS的疗效及其对患者认知功能的影响。
本研究纳入了2019年7月至2022年7月在郑州大学第一附属医院接受治疗的114例TRS患者。除基本的OLZ + AMI治疗外，对照组（Con组）54例接受改良电休克治疗，而研究组（Res组）60例接受rTMS治疗。收集两组患者的疗效、安全性（嗜睡、头痛、恶心、呕吐或记忆障碍的发生率）、阳性和阴性症状量表、蒙特利尔认知评估量表和精神分裂症生活质量量表数据进行比较分析。
与Con组相比，Res组的总体缓解率更高，安全性更好。此外，Res组治疗后阳性和阴性症状量表及精神分裂症生活质量量表评分显著降低，低于Con组。此外，Res组蒙特利尔认知评估量表评分显著升高，高于Con组。
rTMS联合OLZ + AMI治疗TRS有效且安全。此外，它可以缓解患者的精神症状，改善其认知功能和生活质量，具有较高的临床应用价值。
