| BackgroundDepression is a common mental disorder with high incidence and disability rate,characterized by persistent depression,and interest or energy loss.It is often accompanied by many changes(e.g.,psycho physiological,cognitive,behavioral and interpersonal relationship).Repetitive transcranial magnetic stimulation(r TMS)is a new non-invasive neuroelectrophysiological technique,widely used in the treatment of depression.Its mechanism may be that r TMS regulates cerebral cortex by setting different parameters.Although some progress have been obtained in the treatment of depression by r TMS so far,the influence of different parameters of r TMS(e.g.,stimulation intensity,stimulation frequency,treatment times,Liaocheng)on the treatment effect of depression still needs to be studied,because of the lack of relevant research.Therefore,we compared the different frequencies of r TMS combined with selective serotonin reuptake inhibitor(SSRIs)in the treatment of depression patients when the treatment parameters(stimulation intensity,stimulation site,stimulation amount and treatment time)are the same.In order to find out the difference of curative effect and the influence on cognitive function of patients with depression,and to explore the effective parameter standard of r TMS in antidepressant treatment.ObjectivesTo compare the therapeutic effect of different stimulation frequency of r TMS combined with escitalopram on depression,and to explore the effect on cognitive function of depression patients.MethodsA total of 88 patients,meeting the International Statistical Classification of Diseases and Related Health Problems 10th Revision diagnostic criteria,were randomly divided into high-frequency group(10Hz)and low-frequency group(1Hz),pseudostimulant group,and escitalopram group.r TMS was treated 5 times a week for 4 weeks.At the time nodes of baseline,1 week,2 weeks and 4 weeks,professional researchers evaluated the17-Hamilton rating scales of depression(17-HAMD),the Hamilton Anxiety Scale(HAMA)and cognitive function tests(Hopkins Verbal Learning Test-Revised;Symbol Coding;Verbal Fluency:Animal Naming;Trail Making Test).Single factor analysis of variance and chi-square test were used for statistical analysis of experimental datas.LSD test or Games-Howell method was used for multiple comparison.The test levelαwas 0.05.Results1.After 4 weeks of treatment,there was a significant difference in the score reduction rate of HAMD among the four groups(χ~2=19.927,P<0.05).2.After 2 weeks of treatment,compared with the drug group,the HAMD scores in the high frequency group,the low frequency group and the pseudo stimulation group decreased significantly(P<0.05).After 4 weeks of treatment,compared with the drug group,the HAMD scores in the high frequency and the low frequency group decreased significantly,the difference was statistically significant(P<0.05).After 1,2 and 4 weeks of treatment,compared with the drug group,the HAMD reduction rate of the high frequency group,the low frequency group and the pseudo stimulation group was significantly lower;compared with the pseudo stimulation group,the HAMD reduction rate of the high frequency group was significantly lower,the difference was statistically significant(P<0.05).3.After 2 weeks of treatment,compared with the drug group,the HAMA scores in the high frequency group decreased significantly(P<0.05);After 4 weeks of treatment,compared with the drug group,the HAMA scores in the high frequency group and the low frequency group decreased significantly(P<0.05).At the first week of treatment,compared with the drug group,the HAMA reduction rate in the high frequency group and the low frequency group was significantly lower;compared with the pseudo stimulation group,the HAMA reduction rate in the high frequency group was significantly lower;after2 weeks of treatment,compared with the drug group,HAMA reduction rate of high frequency group,low frequency group and pseudo stimulation group decreased significantly;compared with pseudo stimulation group,HAMA reduction rate of high frequency group decreased significantly;compared with drug group,compared with pseudo stimulation group,compared with low frequency group,HAMA reduction rate of high frequency group decreased significantly(P<0.05)4.There was no significant difference in the total scores of Hopkins vocabulary learning test revision(HVLT-R),symbol coding,connection test and verbal fluency between the treatment groups before and after 1week treatment(P>0.05).After 2 weeks of treatment,the verbal fluency scores in high frequency group was significantly higher than that in pseudo stimulation group and drug group(P<0.05).After 4 weeks of treatment,the symbol coding scores of the high frequency group and the low frequency group were significantly higher than those of the pseudo stimulation group(P<0.05);the connection test scores of the high frequency group,the low frequency group and the drug group were significantly lower than those of the pseudo stimulation group(P<0.05);the verbal fluency scores of the high frequency group were significantly higher than those of the drug group and the pseudo stimulation group(P<0.05).Conclusions1.Dynamic observation on the curative effect of different frequencies of r TMS combined with SSRIs in the treatment of depression patients are better than single application of SSRIs.2.The therapeutic effect of high frequency group was significantly better than that of low frequency group,pseudo stimulation group and drug group.3.High frequency r TMS can significantly improve the speech learning and memory function of patients with depression compared with low frequency group,pseudo stimulation group and drug group. |
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