《中国康复理论与实践》 ›› 2015, Vol. 21 ›› Issue (06): 689-694.

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θ短阵快速脉冲刺激模式重复经颅磁刺激对慢性精神分裂症患者执行功能的影响

甄莉丽,易峰,赵幸福,蒋幸衍   

  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-06-25 发布日期:2015-06-25

Effects of Repetitive Transcranial Magnetic Stimulation with Theta Burst Stimulation Paradigm on Executive Function in Patients with Chronic Schizophrenia

ZHEN Li-li, YI Feng, ZHAO Xing-fu, JIANG Xing-yan   

  1. Clinical Department of Wuxi Mental Health Center, Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214151, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-06-25 Online:2015-06-25

摘要: 目的 研究θ短阵快速脉冲刺激(TBS)模式的重复经颅磁刺激(rTMS)对慢性精神分裂症患者执行功能的影响。方法收集符合美国《精神障碍诊断与统计手册》第四版(DSM-Ⅳ)诊断标准的慢性精神分裂症患者60例,随机分为TBS组(n=30)和伪刺激组(n=30),予以4周的rTMS干预或伪刺激。干预前后对所有受试者予以数字广度测验、空间广度测验及威斯康星卡片分类测验(WCST)评估。结果 与干预前相比,TBS组干预后的数字广度、空间广度测验的数字广度正序分及空间广度总分、正序分均升高(均P<0.05),WSCT的选择错误率、持续性错误数及持续性错误的百分数降低,概念化水平百分数升高(均P<0.05);而伪刺激组数字广度、空间广度及 WSCT 各项目评分的干预前后比较均无变化(均 P>0.05);干预后两组间各项目评分均有显著性差异(均 P<0.05)。结论 TBS模式的rTMS能够改善慢性精神分裂症患者的执行功能,并促进康复。

关键词: 慢性精神分裂症, 重复经颅磁刺激, θ短阵快速脉冲模式, 执行功能, 精神康复

Abstract: Objective To explore the effect of theta burst stimulation (TBS) paradigm of repetitive transcranial magnetic stimulation (rTMS) on executive function in patients with chronic schizophrenia. Methods 60 patients meeting DSM-IV for chronic schizophrenia disorders criteria were enrolled. They were randomly divided into TBS group (n=30) and sham intervention group (n=30). They were assessed with digit span performance, space span performance and Wisconsin Card Sorting Test (WCST) before and 4 weeks after intervention. Results After intervention, the forward score of digit span performance, the total score and forward score of space span performance increased (P<0.05), the error selection percentage, the error selection number and the percentage of error number of WCST decreased, the percentage of conceptual level of WCST increased (P<0.05) in the TBS group. However, there was no significant difference in the digit span performance, space span performance and WSCT in the sham intervention group (P>0.05). There was significant difference in all the items between 2 groups after intervention (P<0.05). Conclusion TBS paradigm of rTMS could improve the executive function in schizophrenic patients.

Key words: chronic schizophrenia, repetitive transcranial magnetic stimulate, theta burst stimulation, executive function, psychiatric rehabilitation