重复经颅磁刺激联合利培酮对首发精神分裂症患者海马白质完整性的影响

摘要

目的 探讨重复经颅磁刺激(rTMS)联合利培酮治疗对首发精神分裂症患者海马白质完整性的影响及其与临床疗效的关系.方法 将28例精神分裂症患者随机双盲分为研究组和对照组,研究组给予rTMS联合利培酮治疗,对照组给予利培酮联合假rTMS治疗,共观察6周.两组分别于治疗前和治疗后第6周末进行阳性和阴性综合征量表(PANSS)评定及弥散张量成像(DTI)扫描.结果 治疗后两组PANSS各因子分及总分均低于治疗前(P＜0.05),治疗后研究组左侧海马的FA值高于治疗前(P＜0.05);研究组PANSS阳性因子分低于对照组(P＜0.05).研究组的FA增分值与PANSS阳性因子减分呈正相关(P＜0.05).结论 重复经颅磁刺激联合利培酮可改善首发精神分裂症患者的l床症状及左侧海马白质完整性,两者之间存在一定相关性.%Objective To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) combined with risperidone to improve white matter integrity on left hippocampus in patients with first-episode schizophrenia.Methods A total of 28 patients with schizophrenia were randomly divided into study group with rTMS combined with risperidone and control group with sham-rTMS combined with risperidone for 6 weeks of treatment.They were assessed with Positive and Negative Syndrome Scale (PANSS) and examined with diffusion tensor imaging(DTI) before and after treatment.Results The total score and all factor scores of PANSS in both groups after treatment were all significantly lower than those before treatment(P ＜ 0.05).In study group,the FA value of white matter on left hippocampus after treatment was significantly higher than that before treatment(P ＜0.05)and the positive factor score of PANSS was significantly lower than that in control group(P ＜ 0.05).In study group,the increased FA value was positively correlated with the decreased positive factor score of PANSS (P ＜ 0.05).Conclusion It's effective for rTMS combined with risperidone to improve the clinical symptoms and white matter integrity on left hippocampus in patients with first-episode schizophrenia and there exists some correlation between them.