【摘要】 目的比较高频与低频重复经颅磁刺激联合舍曲林治疗帕金森病(PD)患者伴抑郁的临床疗效和安全性。方法70例帕金森病伴抑郁患者在舍曲林治疗基础上以随机数字表分为3组,低频刺激组(n=22)给予左前额叶背外侧rTMS治疗,刺激频率1Hz;高频刺激组(n=25)给予右前额叶背外侧rTMS治疗,刺激频率10Hz;假刺激组(n=23)随机给予左右侧相应部位伪刺激治疗,治疗前及治疗3周末采用汉密尔顿抑郁量表(HAMD-17)和帕金森病统一评分量表(UPDRS)对3组患者进行评分。观察各量表评分相对基线值的变化情况并进行组间比较,记录各组治疗期间的不良反应。结果入组时,3组患者间HAMD得分和UPDRS得分差异无显著性(P>0.05)。干预后,假刺激组无明显改变;低频刺激组和高频刺激组患者HAMD得分和UPDRS得分均明显较入组时改善,差异有统计学意义(P<0.05);而高频刺激组患者HAMD得分比低频刺激组患者更低,差异有统计学意义(P<0.05)。结论前额叶的高频与低频重复经颅磁刺激均具有改善帕金森患者的运动症状及抑郁症状的双重作用,临床疗效确切且不良反应少。更多还原

【Abstract】 Objective To investigate application effect and safety on low and high frequency repetitive transcranial magnetic stimulation joint sertraline in the treatment of Parkinson’s disease in patients depression.Methods 70 patients with Parkinson’s disease who were divided into 3 groups.Patients in low￣frequency stimulation group(n=22) were given dorsolateral prefrontal cortex rTMS,stimulation frequency 1Hz.Patients in high￣frequency stimulation group were given fight DLPFC rTMS.Patients in fake stimulation group(n=23) were given pseudo-stimulation therapy of left and right side corresponding parts.After three weeks,the scores of hamilton depression scale scores and UPDRS were scored in three groups.The changes of scale score from baseline values were observed and compared between groups,each group was recorded adverse reactions during the treatment.Results There was no significant difference between HAMD score and UPDRS score in the three groups before treatment.After intervention,fake stimulation group had no significant changes;The scores of HAMD and UPDRS was obviously improved(P<0.05) in low ￣frequency stimulation group and high￣frequency stimulation group.HAMD score of high￣frequency stimulation group was lower than that in low￣frequency stimulation group.Difference was statistically significant(P<0.05).Conclusion High frequency and low frequency prefrontal simulated repetitively all have dual role of improving motor symptoms of Parkinson’s patients and depressive symptoms.Clinical efficacy is safe,reliable.And it has less adverse reaction.更多还原