CAJ | 학술논문

目的探讨不同频率重复经颅磁刺激(rTMS)治疗迟发性运动障碍(TD)的疗效.方法长期服用抗精神病药所致迟发性运动障碍的精神分裂症患者,随机给予1 Hz(低频)和10 Hz(高频)的rTMS治疗4周,每周治疗5d.中间休息2周.分别在治疗前和治疗后进行异常不自主运动评定量表(AIMS)和锥体外系副反应量表(RESES)评定,评分变化作为疗效和副反应评价指标.结果低频组经rTMS治疗后只有上肢的不自主运动改善[治疗前(2.6±1.0)分,治疗后(1.8±1.1)分],差异有统计学意义(P＜0.05).高频组经rTMS治疗后多个量表分下降,其中上肢[治疗前(1.9±1.2)分,治疗后(0.8±0.9)分]、唇及口周[治疗前(1.0±0.8)分,治疗后(0.3±0.5)分]和舌[治疗前(2.6±0.9)分,治疗后(1.7±0.9)分]及总量表分[治疗前(7.7±3.0)分,治疗后(4.2±1.7)分]评分治疗前后差异有统计学意义(P＜ 0.05或＜0.01).另外,两组间在下肢和总量表分减分率方面差异有统计学意义(P＜0.05).结论 rTMS治疗TD有效,且高频(10 Hz)组治疗TD效果好.
목적 탐토불동빈솔중복경로자자격(rTMS)치료지발성운동장애(TD)적료효.방법 장기복용항정신병약소치지발성운동장애적정신분렬증환자,수궤급여1 Hz(저빈)화10 Hz(고빈)적rTMS치료4주,매주치료5d.중간휴식2주.분별재치료전화치료후진행이상불자주운동평정량표(AIMS)화추체외계부반응량표(RESES)평정,평분변화작위료효화부반응평개지표.결과 저빈조경rTMS치료후지유상지적불자주운동개선[치료전(2.6±1.0)분,치료후(1.8±1.1)분],차이유통계학의의(P＜0.05).고빈조경rTMS치료후다개량표분하강,기중상지[치료전(1.9±1.2)분,치료후(0.8±0.9)분]、진급구주[치료전(1.0±0.8)분,치료후(0.3±0.5)분]화설[치료전(2.6±0.9)분,치료후(1.7±0.9)분]급총량표분[치료전(7.7±3.0)분,치료후(4.2±1.7)분]평분치료전후차이유통계학의의(P＜ 0.05혹＜0.01).령외,량조간재하지화총량표분감분솔방면차이유통계학의의(P＜0.05).결론 rTMS치료TD유효,차고빈(10 Hz)조치료TD효과호.
Objective To investigate the effect of different frequency of repetitive transcranial magnetic stimulation (rTMS)on tardive dyskinesia (TD).Methods Schizophrenia combined with antipsychotic-induced TD were screened.All patients were planed to receive 1Hz or 10Hz rTMS for 4 weeks in which two weeks' break was inserted at end of 2nd weekend.The curative effect and side effects were assessed by abnormal involuntary movement scale(AIMS) and rating scale for extrapyramidal side effects(RSESE) respectively at before and after treatment.Results In the 1Hz group,only Involuntary movements of the upper extremities were improved after rTMS treatment (before treatment 2.6± 1.0,after treatment 1.8 ± 1.1),the difference was statistically significant (P＜0.05).But in 10Hz group,upper extremities (before treatment 1.9 ± 1.2,0.8 ± 0.9 after treatment),mouth (before treatment 1.0±0.8,after treatment 0.3±0.5),tongue(before treatment 2.6±0.9,after treatment 1.7±0.9),and total score(before treatment 7.7±3.0,after treatment 4.2±1.7) significantly decreased after rTMS treatment(P＜0.05 or ＜0.01).In addition,the reduction rates in both the lower extremities and the total score was statistically different between the two groups (P＜0.05).Conclusion rTMS can reduce the symptom of involuntary movement of TD patients and 10Hz rTMS is better.