Yang Jianquan, Guo Wen, Pang Xuezhou, You Chuanyu, Zhou Chunyang, Gui Yan, Ma Daiyuan
Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
Institute of Materia Medica, North Sichuan Medical College, Sichuan, China.
Medicine (Baltimore). 2024 Dec 6;103(49):e40253. doi: 10.1097/MD.0000000000040253.
To observe the immediate craniocerebral response, changes of spontaneous nerve activity and functional connection after repeated transcranial magnetic stimulation (rTMS) in esophageal cancer patients with depression (ECPD) by functional magnetic resonance imaging (fMRI), and to explore the therapeutic effect, neuroactivity response and mechanism. Eleven patients with ECPD were enrolled to treated with single rTMS. The patients were examined by fMRI before and after the treatment. The changes of low frequency amplitude (ALFF) and the functional connection network between different brain regions of ALFF in patients were compared before and after rTMS treatment. Compared with those before rTMS treatment, the Hamilton Depression Rating Scale (HAMD) score decreased significantly after rTMS treatment (t = -7.63, P = .0001). The ALFF of bilateral putamen, left thalamus, left posterior cingulate gyrus and right middle temporal gyrus decreased significantly (P = .02). In addition, the functional connection between the cortex-limbic system-striatum-thalamus nerve loop increased in patients after rTMS treatment. rTMS may achieve the effect of rehabilitation treatment by improving the spontaneous neural activity and regulating the neural connection network of cortical-limbic systems-triatum-thalamus loop in ECPD.
通过功能磁共振成像（fMRI）观察重复经颅磁刺激（rTMS）对食管癌伴抑郁患者（ECPD）即刻的颅脑反应、自发神经活动变化及功能连接，探讨其治疗效果、神经活动反应及机制。纳入11例ECPD患者接受单次rTMS治疗。治疗前后对患者进行fMRI检查。比较rTMS治疗前后患者低频振幅（ALFF）及ALFF在不同脑区之间的功能连接网络变化。与rTMS治疗前相比，治疗后汉密尔顿抑郁量表（HAMD）评分显著降低（t = -7.63，P = .0001）。双侧壳核、左侧丘脑、左侧后扣带回及右侧颞中回的ALFF显著降低（P = .02）。此外，rTMS治疗后患者皮质-边缘系统-纹状体-丘脑神经环路之间的功能连接增强。rTMS可能通过改善ECPD患者的自发神经活动及调节皮质-边缘系统-纹状体-丘脑环路的神经连接网络来达到康复治疗效果。
