CAJ | 학술논문

目的：探讨重复经颅磁刺激（ rTMS）对以阴性症状为主的精神分裂症患者感觉门控P50缺陷的影响。方法30例以阴性症状为主的、采用利培酮治疗的精神分裂症患者随机分为rTMS真刺激组（研究组，15例）及rTMS伪刺激组（对照组，15例），分别接受20次rTMS治疗。治疗开始及疗程结束时测定P50，P50实验模式为听觉条件刺激（S1）测试刺激（S2）模式。并应用阴性症状量表（SANS）评定疗效。结果两组治疗后SANS评分均低于治疗前（P＜0．001），且治疗后研究组评分低于对照组（P＜0．001）。治疗前P50测量指标在两组患者之间差异均无统计学意义（P＞0．05），治疗前后比较，两组S1潜伏期和波幅未发现明显差异（P＞0．05），研究组S2潜伏期和波幅较治疗前和对照组缩短和降低（P＜0．05），S2/S1比值和P50异常比率较对照组明显降低（P＜0．05）。结论 rTMS结合药物治疗可以改善精神分裂症患者的阴性症状，同时改善精神分裂症的感觉门控P50抑制缺陷。
목적：탐토중복경로자자격（ rTMS）대이음성증상위주적정신분렬증환자감각문공P50결함적영향。방법30례이음성증상위주적、채용리배동치료적정신분렬증환자수궤분위rTMS진자격조（연구조，15례）급rTMS위자격조（대조조，15례），분별접수20차rTMS치료。치료개시급료정결속시측정P50，P50실험모식위은각조건자격（S1）측시자격（S2）모식。병응용음성증상량표（SANS）평정료효。결과량조치료후SANS평분균저우치료전（P＜0．001），차치료후연구조평분저우대조조（P＜0．001）。치료전P50측량지표재량조환자지간차이균무통계학의의（P＞0．05），치료전후비교，량조S1잠복기화파폭미발현명현차이（P＞0．05），연구조S2잠복기화파폭교치료전화대조조축단화강저（P＜0．05），S2/S1비치화P50이상비솔교대조조명현강저（P＜0．05）。결론 rTMS결합약물치료가이개선정신분렬증환자적음성증상，동시개선정신분렬증적감각문공P50억제결함。
Objective To explore the effect of repetitive transcranial magnetic stimulation ( rTMS) on sensory gating P50 deficit in schizophrenia patients that characterized with negative symptoms .Methods 30 schizophrenia patients with predominant negative symptoms and received risperidone treatment were randomly divided into two groups-real rTMS treatment group ( research group , n =15 ) and sham rTMS treatment group (control group, n=15).Each patient in the research group received 20 rTMS sessions over 4weeks that delivered theta burst stimulation ( TBS ) to the left dorsolateral prefrontal cortex .All patients fulfilled the evaluation of sensory gating (SG) P50 with the conditioning (S1)-testing (S2) paradigm before rTMS treatment and 4 weeks after treatment.Efficacy was evaluated blindly using the Scale for the Assessment of Negative Symptoms (SANS). Results 4 weeks after treatment , the SANS scores were reduced remarkably than those before treatment in both two group, and the scores in research group was lower than that in control group (P<0.001).There was no significant difference in P50 parameters between the two groups before treatment ( P >0.05).No significant difference was found in S 1 latency and amplitude between the two groups after treatment .The S2 amplitude and latency, the S2/S1 ratio and percentage of abnormal P50 in research group were lower than control (P<0.05). Conclusions rTMS combined with medicine treatment could improve the negative symptoms and the deficit in SG P50 nhibition of schizophrenia .