| BackgroundSchizophrenia is a highly disabling severe psychiatric disorder with poor prognosis in the long-term course,and many patients gradually become chronic.Chronic patients account for about 30% in psychiatric hospitals.If social welfare assistance is added,the proportion of patients may be higher.About 70% of them are mainly negative symptoms and cognitive disorders,and about 40% of them have poor treatment effect,causing serious social burden.Repetitive transcranial magnetic stimulation is a non-invasive physical therapy for schizophrenia.Research shows that different modes and parameters of repetitive transcranial magnetic stimulation have different effects on different symptoms and cognitive improvement of schizophrenia.The purpose of this study is to investigate the effects of assisted high-frequency repetitive transcranial magnetic stimulation on negative symptoms and cognitive dysfunction in patients with chronic schizophrenia in order to provide a theoretical basis for its treatment.ObjectivesTo analyze the effect of assisted high-frequency rTMS on negative symptoms and cognitive function in patients with chronic schizophrenia,and to explore the relationship between negative symptoms and cognitive function in patients with chronic schizophrenia,and provide evidence for clinical treatment.Methods1.The 96 patients with chronic schizophrenia were divided into three groups according to the random number table method,32 cases in each group,which were respectively high-frequency group(given rTMS of 10 Hz and drug treatment),pseudo stimulation group(given simulated of 10 Hz and drug treatment)and control group(drug treatment),each group has 30 patients completed.2.At baseline and after 4 and 8 weeks of treatment,the PANSS was used to assess mental symptoms including negative symptoms,and the BNSS was used to mainly evaluate negative symptoms.3.At baseline and after 4 and 8 weeks of treatment,The event-related potential P300 latency and amplitude were used to evaluate patients’ psychological activities on the basis of physiology.The BACS was used to assess cognitive functions such as speech,coordination,exercise,understanding and response.4.SPSS 20.0 software was used for statistical analysis.The results of measurement data such as age,years of education,and course of disease are expressed by(sx ±),were in accordance with the normal distribution,and analysis of variance is used;Chi-square test is used for the count data of gender.The results of measurement data such as PANSS score,BNSS score,P300 result and BACS score are represented by(sx ±),and repeated measurement analysis of variance is used.The correlation analysis was in accordance with the normal distribution using Pearson correlation analysis.The difference was statistically significant at P<0.05.Results1.General informationBefore treatment,the three groups of patients showed no statistically significant differences between the groups in terms of age,gender,years of education,and course of disease(P=0.794,P=0.561,P=0.511,P=0.849).At the baseline level,there was a significant correlation between the negative symptoms score of the PANSS scale and the BNSS scale score in the high-frequency group,pseudo-stimulation group,and control group(r=0.759、P<0.001,r =0.899、P<0.001,r =0.939、P<0.001).2.The result of the PANSS and BNSS scoreAt the baseline level,there was no significant difference in PANSS subscales,total scores and BNSS scores among the high-frequency group,pseudo stimulation group and control group(all P>0.05).After 4 and 8 weeks of treatment,the negative symptom score,general psychopathology score,total score and BNSS score in the high frequency group were all decreased(all P<0.05),compared with the pseudo stimulation group and the control group,the difference was statistically significant(all P<0.05);There was no significant difference in negative symptom score,general psychopathology score,total score of the PANSS score and the BNSS score between the pseudo stimulation group and the control group(all P>0.05).3.The result of the P300 amplitude and latencyAt the baseline level,there was no significant difference in the P300 amplitude and latency among the high-frequency group,pseudo stimulation group and control group(all P>0.05).After 4 and 8 weeks of treatment,Compared with the pseudo-stimulation group and the control group,the high-frequency group had a statistically significant difference in the increase of P300 amplitude and shortening of the latency period(all P<0.05);There was no significant difference in the P300 amplitude and latency between the pseudo stimulation group and the control group(all P>0.05).4.The result of the BACS scale scoreAt the baseline level,there was no significant difference in the VM、DS、TM、SC、VF、WF and TOL of the BACS scale score among the high-frequency group,pseudo stimulation group and control group(all P > 0.05).After 4 and 8 weeks of treatment,There was no significant difference among the VM,DS,TM and WF of the BACS scale score among high-frequency group,pseudo stimulation group and control group(all P<0.05);the VF and TOL of the BACS scale score of high-frequency group were significantly different from those of pseudo stimulation group and control group(all P<0.05);There was significant difference between high-frequency group and pseudo stimulation group in the SC of the BACS scale score(P<0.05),there was no significant difference between high-frequency group and control group in the SC of the BACS scale score(P>0.05),there was no significant difference between the pseudo stimulation group and the control group in the VF,SC and TOL of the BACS scale score(P>0.05).5.Correlation analysisAt the baseline level,compared with P300 amplitude,VM,DS,TM,WF,SC,and TOL,there was a statistically significant negatively correlation(all P>0.05)in the PANSS negative symptom score and BNSS score;compared with the P300 latency,there was a statistically significant positive correlation(P<0.05).After 4 and 8 weeks of treatment,compared with the DS、TM、VM、TOL and WF,there was a statistically significant negatively correlation in the PANSS negative symptom score and BNSS score of the high-frequency group(all P>0.05).Conclusions1.Assisted high-frequency rTMS plays a better role in improving the negative symptoms of patients.2.Assisted high-frequency rTMS plays a better role in the improvement of problem-solving ability and speech fluency.3.There is a correlation between negative symptoms and cognitive impairment in patients with chronic schizophrenia,but the improvement degree is different after high frequency rTMS. |
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