Clinical Intervention Effect Of Transcranial Magnetic Stimulation On Patients With Obsessive-compulsive Disorder

Objective:Obsessive-compulsive disorder is a common mental illness,which is mainly manifested by obsessive and compulsive behavior.And usually accompanied by depression and anxiety.TMS is a non-invasive physiotherapy,which has been widely used in the treatment of OCD,while d TMS in the treatment of OCD is rare,and lack of comparison of the clinical effects of the two different stimulation methods.The purpose of this study is to compare and analyze the clinical therapeutic effect of d TMS and r TMS stimulation on patients with OCD and the intervention effect of d TMS on the response inhibition ability of OCD patients.Methods:Study 1:21 patients with OCD were given d TMS for two weeks（10 times）.According to the intensity of stimulation,they were divided into two groups.Y-BOCS,HAMD-17,HAMA and Behavioral tests（Stroop task,SST）were used to evaluate before intervention,one week after intervention and after intervention.Study 2:Another 20 patients with OCD were treated with r TMS for 10 times,and the patients in the group were only evaluated by scales.Results:study 1:There was no significant difference in the scores of the three scales between the high intensity d TMS group and the low intensity d TMS group at baseline.After intervention,the time main effect was significant in Y-BOCS scores(F_（2,18）=49.28,P<0.001,partialη²=0.72),and Y-BOCS scores decreased significantly（P<0.001）,and there was no group main effect(F_（1,19）=0.10,P=0.76,partialη²<0.001)and the interaction of time×group(F_（2,18）=0.93,P=0.39,partialη²=0.05).Before intervention（P=0.87）,intervention for 1 week（P=0.89）and after intervention treatment（P=0.40,）,the simple effects of each group were not significant;The simple effect of d TMS intervention time with two intensities is significant（all P<0.001）;In HAMD-17scores,the time main effect was significant(F_（2,18）=16.60,P<0.001,partialη²=0.65),the scores decreased significantly（P<0.001）.There was no group main effect(F_（1,19）=0.002,P=0.96,partialη²<0.001)and time×group interaction(F_（2,18）=0.29,P=0.75,partialη²=0.03).Before intervention（P=0.82）,intervention for 1 week（P=0.92）and after intervention treatment（P=0.72）,the simple effects of each group were not significant;The simple effect of d TMS intervention time with two intensities is significant（all P<0.01）;In HAMA score,the time main effect was significant(F_（2,18）=83.92,P<0.001,partialη²=0.82),and the scores decreased significantly（P<0.001）,the main effects of the two groups were not significant(F_（1,19）=1.58,P=0.22,partialη²=0.08).The interaction of time×group was not significant(F_（2,18）=0.54,P=0.59,partialη²=0.03).Before intervention（P=0.37）,1 week of intervention（P=0.22）and after intervention treatment（P=0.25）,the simple effects of the group were not significant,while the simple effects of d TMS intervention time of both intensities were significant（all P<0.001）.There was no significant difference in the indexes of Stroop task and SST task between the two groups before and after intervention（P>0.05）.Study 2:d TMS group and r TMS group had no significant differences on the three scales at baselines（P>0.05）.In Y-BOCS score,the time main effect was significant(F_（2,38）=63.78,P<0.001,partialη²=0.62),and the scores were significantly decreased（P<0.001）,and there was no group main effect(F_（1,39）=0.10,P=0.75,partialη²<0.001)and the interaction time×group(F_（2,38）=1.01,P=0.36,partialη²=0.03);In HAMD-17 scores,the time main effect was significant(F_（2,38）=17.48,P<0.001,partialη²=0.48),and the scores were significantly decreased（P<0.01）,but the main effect was not significant in each group(F_（1,39）=1.56,P=0.22,partialη²=0.04).The interaction of time×group was not significant(F_（2,38）=0.32,P=0.73,partialη²=0.02).In HAMA scores,the time main effect was significant(F_（2,38）=86.26,P<0.001 partialη²=0.69),and the scores were significantly decreased（P<0.001）,and the main effect was significant(F_（1,39）=7.65,P=0.01,partialη²=0.16).The interaction of time×group was significant(F_（2,38）=5.00,P=0.01,partialη²=0.11).Conclusion:After 10 treatments,no matter high intensity or low intensity can improve the obsessive-compulsive symptoms of OCD patients.r TMS and d TMS can significantly improve the obsessive-compulsive symptoms and relieve anxiety and depression of OCD patients,and there is no significant difference between the two groups.