磁惊厥治疗与无抽搐电痉挛治疗抑郁发作的早期疗效及对认知功能的影响

doi:10.3969/j.issn.1006-7795.2022.02.013

首都医科大学学报 ›› 2022, Vol. 43 ›› Issue (2): 239-243.doi: 10.3969/j.issn.1006-7795.2022.02.013

• 精神疾病神经调控和康复技术研究 • 上一篇下一篇

磁惊厥治疗与无抽搐电痉挛治疗抑郁发作的早期疗效及对认知功能的影响

任艳萍^1,2, 张俊岩^1,2, 吴涵^1,2, 罗炯^1,2, 杨春林^1,2, 马辛^1,2, 姜玮^1,2*

1.首都医科大学附属北京安定医院精神科精神疾病诊断与治疗北京市重点实验室&国家精神心理疾病临床医学研究中心,北京 100088;
2.首都医科大学人脑保护高精尖创新中心,北京 100069

收稿日期:2021-11-10 出版日期:2022-04-21 发布日期:2022-04-14
基金资助:
首都卫生发展科研专项(2018-3-1171),北京市科学技术委员会科技重大专项(D171100007017001)。

Comparison on the early efficacy and cognitive effect of magnetic seizure therapy and modified electroconvulsive therapy for depressive episodes

Ren Yanping^1,2, Zhang Junyan^1,2, Wu Han^1,2, Luo Jiong^1,2, Yang Chunlin^1,2, Ma Xin^1,2, Jiang Wei^1,2*

1. Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing Key Laboratory of Mental Disorders & The National Clinical Research Center for Mental Disorders, Beijing 100088, China;
2. Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China

Received:2021-11-10 Online:2022-04-21 Published:2022-04-14
Contact: *E-mail:jw680315@163.com
Supported by:
Capital's Funds for Health Improvement and Research(2018-3-1171),Beijing Municipal Science & Technology Commission (D171100007017001).

摘要/Abstract

摘要： 目的比较磁惊厥治疗(magnetic seizure therapy, MST)与无抽搐电休克治疗(modified electroconvulsive therapy, MECT)对抑郁发作早期的疗效及对认知功能的影响。方法入组45例抑郁发作患者,分别接受MST和MECT治疗。采用汉密尔顿抑郁量表-17项(Hamilton Depression Scale-17 Item, HAMD-17),汉密尔顿焦虑量表(Hamilton Anxiety Scale, HAMA),临床总体印象量表(Clinical Global Impression Scale,CGI)进行临床症状评估,采用重复成套神经心理状态测验(the Repeatable Battery for the Assessment of Neuropsychological Status, RBANS)及简易智力状态检查量表(Mini-mental State Examination, MMSE)进行认知功能评估。评估时间点包括基线、治疗3次后、治疗6次后。结果双因素重复测量方差分析显示,两组间治疗前后HAMD-17、HAMA、CGI-S、CGI-I评分差异均无统计学意义(P_组间>0.05),其中HAMD-17、HAMA、CGI-S评分均随治疗时间的延长逐渐降低(P_时间<0.05)。两组RBANS总分,均随治疗时间延长逐渐升高(P_时间<0.05);各时点,MST组RBANS总分高于MECT组,组间比较差异有统计学意义(P_组间<0.05),且随时间延长,MST的治疗效应组间增大(P_交互<0.05)。治疗3次和治疗6次后,HAMD减分率两组间比较差异无统计学意义。结论 MST治疗抑郁发作早期治疗疗效果与MECT相当,MST治疗6次后可改善患者的部分认知功能。

关键词: 磁惊厥治疗, 无抽搐电休克治疗, 抑郁发作, 早期治疗效果, 认知功能

Abstract: Objective To compare the early efficacy and effect on cognitive function of magnetic seizure therapy (MST) and modified electroconvulsive therapy (MECT) in the treatment of depressive episode. Methods A total of 45 patients with depression were treated with MST or MECT respectively. Hamilton Depression Scale-17 Item (HAMD-17), Hamilton Anxiety Scale (HAMA), and Clinical Global Impression Scale (CGI) was used to evaluate clinical symptoms. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Mini-mental State Examination (MMSE) were used to evaluate cognitive function. The evaluation time points included baseline, after 3 times and 6 times of treatment. Results Repeated measurement ANOVA showed that there was no significant difference in HAMD-17, HAMA, CGI-S and CGI-I scores between the two groups before and after treatment (P_group>0.05). HAMD-17, HAMA and CGI-S scores decreased along with the extension of treatment time (P_time<0.05). The total score of RBANS in both groups increased gradually with the extension of treatment time (P_time<0.05). At each time point, the total score of RBANS in MST group was higher than that in MECT group, with statistically significant difference between the groups (P_group<0.05), and the therapeutic effect of MST increased with time (P_time<0.05). After 3 and 6 times of treatment, there was no significant difference in HAMD score reduction rate between the two groups. Conclusion The early efficacy of MST was comparable to MECT in the treatment of depressive episode. MST improved the cognitive function of patients after 6 treatment times.

Key words: magnetic seizure therapy, modified electroconvulsive therapy, depressive episode, early efficacy, cognitive function

中图分类号:

R749.4

任艳萍, 张俊岩, 吴涵, 罗炯, 杨春林, 马辛, 姜玮. 磁惊厥治疗与无抽搐电痉挛治疗抑郁发作的早期疗效及对认知功能的影响[J]. 首都医科大学学报, 2022, 43(2): 239-243.

Ren Yanping, Zhang Junyan, Wu Han, Luo Jiong, Yang Chunlin, Ma Xin, Jiang Wei. Comparison on the early efficacy and cognitive effect of magnetic seizure therapy and modified electroconvulsive therapy for depressive episodes[J]. Journal of Capital Medical University, 2022, 43(2): 239-243.

参考文献

[1] Smith K. Mental health: a world of depression[J]. Nature, 2014, 515(7526): 181.
[2] 马辛, 李淑然, 向应强, 等. 北京市抑郁症的患病率调查[J]. 中华精神科杂志, 2007, 40(2): 100-103.
[3] Blackburn T P. Depressive disorders: treatment failures and poor prognosis over the last 50 years[J]. Pharmacol Res Perspect, 2019, 7(3): e00472.
[4] Bergfeld I O, Mantione M, Figee M, et al. Treatment-resistant depression and suicidality[J]. J Affect Disord, 2018, 235: 362-367.
[5] Warden D, Rush A J, Trivedi M H, et al. The STAR*D project results: a comprehensive review of findings[J]. Curr Psychiatry Rep, 2007, 9(6): 449-459.
[6] UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis[J]. Lancet, 2003, 361(9360): 799-808.
[7] Hermida A P, Glass O M, Shafi H, et al. Electroconvulsive therapy in depression: current practice and future direction[J]. Psychiatr Clin North Am, 2018, 41(3): 341-353.
[8] Lisanby S H. Update on magnetic seizure therapy: a novel form of convulsive therapy[J]. J ECT, 2002, 18(4): 182-188.
[9] Wilkinson S T, Agbese E, Leslie D L, et al. Identifying recipients of electroconvulsive therapy: data from privately insured americans[J]. Psychiatr Serv, 2018, 69(5): 542-548.
[10] Lisanby S H, Schlaepfer T E, Fisch H U, et al. Magnetic seizure therapy of major depression[J]. Arch Gen Psychiatry, 2001, 58(3): 303-305.
[11] Cretaz E, Brunoni A R, Lafer B. Magnetic seizure therapy for unipolar and bipolar depression: a systematic review[J]. Neural Plast, 2015, 2015: 521398.
[12] Zhang J Y, Ren Y P, Jiang W, et al. Shorter recovery times and better cognitive function-a comparative pilot study of magnetic seizure therapy and electroconvulsive therapy in patients with depressive episodes[J]. Brain Behav, 2020, 10(12): e01900.
[13] Chen M, Yang X H, Liu C J, et al. Comparative efficacy and cognitive function of magnetic seizure therapy vs. electroconvulsive therapy for major depressive disorder: a systematic review and meta-analysis[J]. Transl Psychiatry, 2021, 11(1): 437.
[14] American Psychiatric Association. Diagnostic and statistical manual for mental disorders-text revision[M]. 4th ed. Washington DC: American Psychiatric Association,2000.
[15] Chanpattana W, Chakrabhand S, Techakasem P, et al. Seizure threshold in ECT: Ⅱ. Dose titration vs age and half age methods[J]. J Med Assoc Thai, 2000, 83(3): 278-283.
[16] Daskalakis Z J, Dimitrova J, McClintock S M, et al. Magnetic seizure therapy (MST) for major depressive disorder[J]. Neuropsychopharmacology, 2020, 45(2): 276-282.
[17] Kessler U, Schoeyen H K, Andreassen O A, et al. The effect of electroconvulsive therapy on neurocognitive function in treatment-resistant bipolar disorder depression[J]. J Clin Psychiatry, 2014, 75(11): e1306-e1313.
[18] Kayser S, Bewernick B H, Matusch A, et al. Magnetic seizure therapy in treatment-resistant depression: clinical, neuropsychological and metabolic effects[J]. Psychol Med, 2015, 45(5): 1073-1092.
[19] Lisanby S H, Luber B, Schlaepfer T E, et al. Safety and feasibility of magnetic seizure therapy (MST) in major depression: randomized within-subject comparison with electroconvulsive therapy[J]. Neuropsychopharmacology, 2003, 28(10): 1852-1865.
[20] Kayser S, Bewernick B H, Soehle M, et al. Degree of postictal suppression depends on seizure induction time in magnetic seizure therapy and electroconvulsive therapy[J]. J ECT, 2017, 33(3): 167-175.

磁惊厥治疗与无抽搐电痉挛治疗抑郁发作的早期疗效及对认知功能的影响

Comparison on the early efficacy and cognitive effect of magnetic seizure therapy and modified electroconvulsive therapy for depressive episodes

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	李琼, 赵建华, 刘昊, 王凡, 李青, 陈希妍, 蔡瑞艳, 吴清武, 张健, 吉四辈, 路承彪, 李少敏. 脑白质高信号患者血清CX3CL1水平与认知功能障碍的关系[J]. 首都医科大学学报, 2023, 44(1): 6-12.
[2]	安宇, 边南南, 丁小雨, 常晓娜, 刘佳, 王广. 1型糖尿病伴认知功能损伤小鼠脑组织肠道菌群代谢物的改变[J]. 首都医科大学学报, 2022, 43(4): 622-629.
[3]	许新, 阮祥燕, 鞠蕊, 杨瑜, 程姣姣, 王志坤, Alfred O. Mueck. 中国女性轻度认知障碍的影响因素及其与绝经症状的关系[J]. 首都医科大学学报, 2022, 43(3): 369-374.
[4]	罗炯, 孙丛丛, 潘伟刚, 王丹, 史晓宁, 王茜, 金文青, 梁立荣, 杨春林, 马辛, 任艳萍. 经颅交流电刺激联合抗抑郁药对抑郁发作的疗效及安全性[J]. 首都医科大学学报, 2022, 43(2): 244-248.
[5]	杨柳青, 田红梅, 石汉平. 三种饮食模式与慢性疾病研究进展[J]. 首都医科大学学报, 2022, 43(2): 311-320.
[6]	李志, 张郡, 戴悦萱, 秦明阳, 梁芙茹. 血糖波动对2型糖尿病大鼠认知功能的影响[J]. 首都医科大学学报, 2021, 42(3): 347-353.
[7]	郝淑文, 陈瑛, 丁晖, 赵春松, 梁阔, 薛金花, 蔡彦宁. 阿尔茨海默病、轻度认知功能障碍及主观认知下降患者血液DNA中多个基因的甲基化分析[J]. 首都医科大学学报, 2021, 42(3): 447-452.
[8]	张颖, 王若梅, 李刚. 稳定期精神分裂症患者认知功能、情绪管理水平及其影响因素分析[J]. 首都医科大学学报, 2021, 42(1): 143-147.
[9]	吴凤芝, 宁艳哲, 贾竑晓. 脾虚证患者认知功能的临床特征[J]. 首都医科大学学报, 2020, 41(1): 55-58.
[10]	宋楠, 贾竑晓. 人格解体患者认知功能及与临床症状和社会功能的相关性[J]. 首都医科大学学报, 2020, 41(1): 59-63.
[11]	李森, 黄安琪, 郭健飞, 白洁, 张光珍, 王婷, 赵咏梅. 沙格列汀对2型糖尿病患者缺血性脑卒中后认知功能的影响[J]. 首都医科大学学报, 2019, 40(5): 715-720.
[12]	陈玉静, 陈文强, 张建新, 刘妍, 吴犀翎, 王建东, 黄小波. 黄芩甙对慢性脑低灌注大鼠认知功能及其对海马内LC-3Ⅱ和Beclin-1表达的影响[J]. 首都医科大学学报, 2019, 40(3): 330-334.
[13]	刘毅, 任艳萍, 姜玮, 马辛. 基于神经心理与生理学评估的精神分裂症无抽搐电休克治疗后认知功能的研究[J]. 首都医科大学学报, 2018, 39(5): 651-656.
[14]	穆珊珊, 吴延, 吴安石, 刘扬. 非心脏手术老年患者术后谵妄及术后认知功能障碍相关危险因素研究[J]. 首都医科大学学报, 2018, 39(3): 366-372.
[15]	朱虹, 职利花, 贾竑晓. 齐拉西酮治疗对精神分裂症患者认知功能和生活质量的治疗效果研究[J]. 首都医科大学学报, 2018, 39(2): 199-203.