| Objectives:To observe the changes of anxiety,depression and sleep quality in healthy young people before and after r TMS stimulation,and to further explore the effects of r TMS stimulation on the prefrontal function of young people by using functional near infrared imaging.Methods:People who saw doctors in the Second People’s Hospital of Yunnan Province from March 1,2022 to October 1,2022,and met the inclusion and exclusion criteria were selected as the study objects.Baseline data of subjects meeting the criteria were collected,including age,sex,education level,past drug use history,history of mental and neurological diseases,etc.Self-rating Depression Scale（SDS）was used for depression,self-rating Anxiety Scale（SAS）for anxiety,and Pittsburgh Sleep Score Scale（PSQI）for recent sleep status.According to the principle of randomization,the enrolled 30 subjects were divided into two groups,16 in the sham group（n=16）and 14 in the intervention group（n=14）.A 14-day intervention was performed by r TMS with a stimulation frequency of 5Hz and a stimulation intensity of 110%of the resting motion threshold,with an interval between 20s,and 15 minutes of stimulation for a total of 2600 pulses.Subjects completed a total of eight interventions over 14 days.The day before the start of the experiment was set as day 0,the day 14 after two weeks of r TMS intervention,and the day 28 after two weeks of intervention.Baseline data of f NIRs,SDS,SAS and PSQI were collected on days 0and 14 of the experiment.SDS,SAS and PSQI scales were evaluated again on the28th day of the experiment.The effect of r TMS intervention was evaluated by comparing the changes of SDS,SAS and PSQI scores and the changes of cerebral hemodynamics before and after the intervention,and the mechanism of the influence of r TMS stimulation on the subjects’emotional state was further explored.Results:After 14 days of r TMS intervention,SDS score and SAS score score of the intervention group on day 14 were significantly lower than those on day 0,and the difference was statistical significance（p<0.05）.PSQI scores in the intervention group were lower on day 14 than on day 0,and the difference was not statistically significant（p>0.05）.SDS scores,SAS scores and PSQI scores of the sham group on day 14 showed no statistical difference compared with day 0（p>0.05）.On day 14,the difference of SDS scores between the sham group and the intervention group was not statistically significant（p>0.05）.On the 14th day of the experiment,there was no statistical difference in SAS score and PSQI score between the sham intervention group and the intervention group（p>0.05）.SDS,SAS and PSQI scores were assessed again on day 28 of the experiment.SDS scores and PSQI scores of the intervention group and the sham group were lower on day 28 than on day 14.The SAS score in the intervention group on day 28 was higher than that on day 14,and the SAS score in the sham group was higher than that on day 14.But there were no statistical difference（p>0.05）.On day 28,there was no significant difference in SDS scores,SAS scores and PSQI scores between the sham group and the intervention group（p>0.05）.The correlation analysis of SDS score,SAS score and PSQI score found that there was a positive correlation between them(SDS and SAS:r=0.57,p=3.681x10-9;SDS and PSQI:r=0.539,p=3.096x10-8;SAS and PSQI:r=0.416,p=0.001).In the n-back task,none of the channels were significantly activated.After two weeks of intervention,the intervention group showed improvement in average accuracy and average reaction time when finishing the digital n-back and spatial n-back tasks,but there was no statistical difference（p>0.05）.In the VFT task,the intervention group showed significant activation of the right inferior frontal cortex（CH19）when compared at baseline（p<0.05）,the left and right inferior frontal cortex（CH14,CH18）showed significant activation after 2 weeks of intervention（p<0.05）.Repeated measurement variance analysis showed that the dominant effect of r TMS was not significant in the two regions（left subfrontal cortex:F=1.184,p=0.286,right subfrontal cortex:F=0.004,p=0.947）.Conclusions:（1）Two consecutive weeks of high frequency r TMS reduced depression,anxiety,and sleep quality scale scores,and the reduction lasted for at least two weeks after the finishing of stimulation.（2）There is a positive correlation between anxiety,depression and sleep quality,indicating that anxiety,depression and sleep quality can affect each other,but the dominant/concomitant and interaction between the two mental states need to be further studied.（3）The detection of cerebral hemodynamic changes by f NIRs may further reveal the effect of r TMS stimulation on improving mental state in young people,and may further explain the intervention mechanism may be the biological effect of r TMS stimulation through the prefrontal lobe. |
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