Efficacy Of Repetitive Transcranial Magnetic Stimulation In Adolescents With Depression And Its Cytokine Effects

Objectives:To investigate the difference in efficacy between pharmacological combined with repetitive transcranial magnetic stimulation(rTMS)and pharmacological treatment in adolescents with depression.To analyze the correlation between cytokines(IL-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IFN-α,IFN-γ,TNF-α)and clinical symptoms.To compare changes in cytokine levels in adolescents with depression after treatment.Methods:1.A total of 90 adolescent depression patients hospitalized in the Department of Psychosomatic Medicine of the First Affiliated Hospital of Nanchang University from January 2021 to December 2021 were selected according to the study criteria and divided into 45 cases in the study group(group A)and 45 cases in the control group(group B)by the random number table method.Group A was treated with sertraline combined with rTMS and group B was treated with sertraline combined with pseudo-stimulation.2.Clinical symptoms were assessed using the 24-item Hamilton Depression Inventory(HAMD-24);cytokine levels were measured by enzyme-linked immunosorbent assay(ELISA).3.To compare the differences between the two groups before treatment in terms of age,gender,education,clinical symptoms,and cytokine levels;to compare the differences in the efficacy of drug combined with rTMS and drug combined with pseudo-stimulation in adolescent depression patients;to analyze the correlation between clinical symptoms and cytokines in adolescent depression patients;to compare the differences in cytokine levels between the two groups after treatment.Results:1.There was no statistically significant difference in the basic information(age,gender,and education level)between the two study groups(P>0.05).2.Before treatment,there was no statistically significant difference in the total HAMD-24 score and each factor score between the two groups(P>0.05);after treatment,the total HAMD-24 score decreased in both groups compared with that before treatment,and the difference was statistically significant(P<0.05);in the categories of total score,work and interest,and arousal,group A(drug combined with rTMS)improved better than group B(drug combined with pseudo-stimulation),and the difference was statistically(P<0.05);after treatment,the total effective rate was 88.89% in group A and 68.89% in group B,with statistically significant differences(P<0.05).No significant adverse reactions were observed during the treatment period in either group.3.Before treatment,the differences in the levels of cytokines(IL-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IFN-α,IFN-γ,TNF-α)between the two groups were not statistically significant(P>0.05);after treatment,the differences in the levels of IL-8 between the two groups were statistically significant(P<0.05).4.The results of Pearson correlation analysis showed that IL-4 and IL-5 levels were negatively correlated with gastrointestinal symptoms(r=-0.564,r=-0.533,P<0.05);IL-8 levels were positively correlated with paranoid symptoms(r=0.529,P<0.05);IL-10 levels were positively correlated with hypochondriac and obsessive-compulsive symptoms(r=0.537,r= 0.516,P<0.05);IL-12p70 levels were positively correlated with depressed mood and suicide(r=0.639,P<0.01;r=0.520,P<0.05);IFN-γ levels were positively correlated with depressed mood and early awakening(r=0.611,r=0.621,P<0.05)and negatively correlated with sexual symptoms(r=-0.631,P<0.01).Conclusion:1.Drug combined with rTMS has better curative effect than single drug treatment for adolescents with depression,and the improvement is better in the categories of work,interest and agitation;and rTMS technology is safe in adolescents.2.The levels of IL-4,IL-5,IL-8,IL-10,IL-12p70 and IFN-γ are correlated with depressive symptoms in adolescents.3.After rTMS treatment,IL-8 levels may be associated with changes in symptoms.