低频重复经颅磁刺激对抑郁症首次发病患者事件相关电位P300的影响

摘要

目的：探讨艾司西酞普兰单用或联合低频经颅重复磁刺激（ rTMS）对首次发病的抑郁症患者事件相关电位 P300的影响。方法：40例首次发病的抑郁患者随机分为两组并均给予草酸艾司西酞普兰治疗；研究组同时联合低频 rTMS，对照组联合伪 rTMS；疗程4周。治疗前后分别进行 P300潜伏期（LP）和波幅（Amp）检测及汉密尔顿抑郁量表17项（HAMD-17）评估。结果：治疗前两组 P300 LP和 Amp 差异无统计学意义；治疗后两组 LP 较治疗前明显缩短（t ＝9.727，7.906；P 均﹤0.05），Amp 显著增高（t ＝-4.173，-2.539；P 均﹤0.05）；且研究组的改善明显优于对照组（t ＝-2.419，2.112；P 均﹤0.05）。治疗后两组 HAMD-17评分均明显降低（t ＝9.475，8.794；P 均﹤0.05）；但两组间差异无统计学意义。结论：艾司西酞普兰联合低频 rTMS 能更有效改善轻中度抑郁症患者的认知功能。%Objective:To explore the influence of low-frequency repetitive tanscranial magnetic simula-tion(rTMS)on event related potential P300 in first-episode patients with depression. Method:Forty first-episode patients with depression were randomly divided into two groups,and all of the patients were treated with escitalopram. While,the study group was combined with low-frequency rTMS,and the control group were com-bined with pseudo rTMS for 4 weeks. Before and after treatment,all of the patients were detected by P300 laten-cy periods(LP)and amplitude(Amp)and assessed by Hamilton depression scale-17(HAMD-17). Results:Before treatment,P300 LP and Amp of the two groups showed no obvious difference. After treatment,P300 LP was significantly decreased and Amp was significantly increased than before treatment in the two groups(t =- 4. 173,- 2. 539;all P ﹤ 0. 05);and the improvement of the study group were better than the control group (t = - 2. 419,2. 112;all P ﹤ 0. 05). The scores of HAMD-17 of the two groups after treatment were significantly lower than before treatment(t = 9. 475,8. 794;all P ﹤ 0. 05);but there was no statistical difference between the two groups. Conclusion:Escitalopram combinated with low-frequency rTMS can improve cognitive function more effectively in patients with mild-to-moderate depression.