iTBS与1 Hz rTMS对老年抑郁症患者抑郁症状及认知功能的影响
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中央高校基本科研业务费专项资金(2018KFYYXJJ113);


Effects of iTBS and 1 Hz rTMS on depressive symptoms and cognitive function in elderly patients with depression
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    摘要:

    目的:探讨间歇性θ爆发式磁刺激(iTBS)与1 Hz重复经颅磁刺激(rTMS)对老年抑郁症患者抑郁症状及认知功能的影响。方法:老年抑郁症患者,按治疗方案不同分为iTBS组(n=30)和1 Hz rTMS组(n=43),两组均接受抗抑郁治疗。此外,iTBS组在左侧前额叶背外侧给予丛内频率50 Hz,丛间频率5 Hz,刺激强度为110%RMT,刺激时间2 s,间歇8 s,重复20次,共600个脉冲,持续200 s; 1 Hz rTMS组在右侧前额叶背外侧给予刺激频率1.0 Hz,刺激强度110%RMT,每日治疗20 min,每次治疗总脉冲数1 200次。两组患者每周相同的固定的时间治疗5次,治疗4周,共20次。于治疗前后使用汉密尔顿抑郁量表24(HAMD-24)、老年抑郁量表(GDS)、Beck自杀意念量表中文版(BSI-CV)、威斯康星卡片分类测试、连线测试A部分进行评估,并记录不良反应发生情况。结果:随着治疗时间的延长,两组患者的HAMD-24、GDS评分均逐渐下降(P<0.05),且iTBS组低于1 Hz rTMS组(P<0.05);治疗4周后,iTBS组患者正确应答数高于1 Hz rTMS组(P<0.05),错误应答数、BSI-CV评分自杀意念强度及自杀危险得分均低于1 Hz rTMS组(P<0.05),TMT-A时间短于1 Hz rTMS组,组间差异有统计学意义(P<0.05);治疗期间,两组患者不良反应总发生率无统计学差异(P>0.05)。结论:iTBS治疗老年抑郁症患者,在改善抑郁症状,减少自杀意念及提高认知能力方面较1 Hz rTMS治疗存在明显优势,且未增加治疗安全风险。

    Abstract:

    Objective:To explore the effects of intermittent theta burst magnetic stimulation(iTBS)and 1 Hz repetitive tran-scranial magnetic stimulation(rTMS)on depressive symptoms and cognitive function in elderly patients with depression.Methods:Eld-erly patients with depression were divided into iTBS group(n=30)and 1 Hz rTMS group(n=43)according to the treatment regi-men.On the basis of antidepressant treatment for both groups,the left dorsolateral prefrontal lobe of the iTBS group was given a stimula-tion frequency of 50 Hz from the internal frequency,5 Hz from the inter-frequency and stimulation strength of 110%RMT,with a stimu-lation time of 2 s,an intermission of 8 s,and a repetition of 20 times,with a total of 600 pulses lasting for 200 s.The 1 Hz rTMS group was given a stimulation frequency of 1.0 Hz and a stimulation intensity of 110%RMT in the dorsolateral right prefrontal lobe,and was treated for 20 min per day,with a total of 1,200 pulses per treatment.Patients in both groups were treated 5 times per week at the same fixed time for 4 weeks for a total of 20 treatments.The Hamilton Depression Scale 24(HAMD-24),Geriatric Depression Scale(GDS),Beck Suicidal Ideation Inventory-Chinese Version(BSI-CV),Wisconsin Card Sorting Test,and Part A of the Connection Test were used for assessment before and after treatment,and adverse reactions during treatment were recorded.Results:With the prolongation of treat-ment time,the HAMD-24 and GDS scores of the two groups gradually decreased(P<0.05),and the HAMD-24 and GDS scores of the iTBS group were lower than those of the 1 Hz rTMS group,and the difference was statistically significant(P<0.05).After4 weeks of treatment,the number of correct responses of the patients in the iTBS group was higher than that of the 1 Hz rTMS group,and the num-ber of incorrect responses,BSI-CV score suicidal ideation intensity and suicide risk were lower than those of the 1 Hz rTMS group,and the TMT-A time was shorter than that of the 1 Hz rTMS group,with a statistically significant difference between the groups(P<0.05).During the treatment period,there was no statistically significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion:There are significant advantages of iTBS over1 Hz rTMS in treating elderly patients with depression in terms of improving depressive symptoms,reducing suicidal ideation,and improving cognitive performance,and there was no increased treatment safety risk.

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周雪莹;徐德毅;尚方杰;. iTBS与1 Hz rTMS对老年抑郁症患者抑郁症状及认知功能的影响[J].川北医学院学报,2025,40(6):703-707.

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  • 在线发布日期: 2025-07-09
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