深部经颅磁刺激改善抑郁症认知损伤及其脑电生理机制
文献类型：学位论文
| 作者 | 李嘉欣 |
| 答辩日期 | 2023-06 |
| 文献子类 | 硕士 |
| 授予单位 | 中国科学院大学 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 王冬梅 |
| 关键词 | 抑郁症 深部经颅磁刺激 认知功能 经颅磁刺激联合脑电技术 物理治疗 |
| 学位名称 | 理学硕士 |
| 学位专业 | 健康心理学 |
| 其他题名 | The Add-on Role of Deeb-Transcranial Magnetic Stimulation on Clinical Symbtoms and Cognitive Function in Major Debressive Disorders and Its Electroencephalograbhic Mechanism |
| 中文摘要 | Objective: Depression is a disabling psychiatric disorder with a high prevalence and is often associated with cognitive impairment, making patients' recovery more difficult. Currently, depression is mainly treated clinically with medications, which have limitations including side effects and little efficacy on improving cognitive functions. In recent years, non-invasive brain stimulation techniques have been gradually applied in clinical practice, among which deep transcranial magnetic stimulation (dTMS) has the characteristics of deep depth and wide range with few side effects and excellent efficacy. This study aimed to investigate the efficacy of dTMS on improving clinical symptoms and cognitive functions in patients with depression, and the brain electrophysiological mechanism underlying its efficacy. Methods: This study included three sub-studies, which explored the cognitive function and electrophysiological characteristics of depression itself, the clinical and cognitive efficacy of dTMS, and the brain electrophysiological mechanisms underlying the efficacy of dTMS, respectively. Study I was cross-sectional and compared clinical symptoms, cognitive function, and brain electrophysiological data between patients with depression and healthy controls. Study II used a clinically randomized controlled experimental design in which the included patients were randomly divided into a dTMS real-stimulation group and a sham-stimulation group, and their clinical symptoms and cognitive functions before and after treatment were compared to illustrate the efficacy of dTMS. Study III was conducted on the basis of Study II and compared the brain electrophysiological features of the real- and sham-stimulation groups to investigate the underlying mechanisms of dTMS in treating depression and improving cognitive impairment. Results: Study I found significant deficits in cognitive function and alterations in the values of TMS一evoked potentials (TEP) in patients with depression, with the changes in TEP being significantly correlated with clinical symptoms and impairment of cognitive function in patients. Study II found a significant decrease in depressive symptoms and anxiety symptoms and a significant increase in cognitive functions in the real-stimulation group after ten sessions of dTMS treatment. Study III found that dTMS intervention had a significant modulating effect on the N100 amplitude and P180 amplitude of TEP, and the changes of these amplitudes were associated with the improvement of patients' clinical symptoms. Moreover, the changes of several characteristic values of TEP in patients were significantly associated with the improvement of cognitive functions, especially immediate memory functions. Conclusion: DTMS can effectively relieve clinical symptoms and improve cognitive functions in patients with depression. The brain electrophysiological mechanism underlying dTMS involves the modulation of excitatory and inhibitory mechanisms in the brain, which may be related to the relief of depressive symptoms, anxiety symptoms and cognitive impairment. |
| 英文摘要 | 目的:抑郁症是一类发病率较高的致残性精神疾病，往往伴发认知障碍，增加了患者康复的困难。目前，临床主要用药物治疗抑郁症，具有一定局限性，且对认知功能的改善效果甚微。近年来，非侵入性脑刺激技术已逐步应用于临床实践。其中，深部经颅磁刺激(deep transcranial magnetic stimulation, dTMS) 具有深度深、范围大、副作用少、疗效好等特点。本研究旨在探索dTMS改善抑郁症患者临床症状和认知功能的疗效，及其脑电生理机制。 方法:三个子研究分别探索了抑郁症的认知功能和脑电生理特征、dTMS 的临床及认知疗效、dTM S起效的脑电生理机制。研究一为横断面研究，比较了抑郁症患者和健康对照组临床症状、认知功能及脑电生理数据。研究二采用临床随机对照实验设计，将患者随机分为dTMS真刺激组与伪刺激组，并比较干预前后临床症状和认知功能，以说明深部TMS的疗效。研究三基于研究二比较了真伪刺激组的脑电生理指标，以探究深部TMS治疗抑郁症、改善认知障碍的脑电生理机制。 结果:研究一发现抑郁症患者存在认知功能的显著缺陷，且在脑电生理上也存在着改变，表现于TMS诱发电位各特征值与健康对照的差异;且TMS诱发电位变化与患者临床症状和认知功能损害显著相关。研究二的结果显示，十次dTM S治疗后，与伪刺激组相比，真刺激组HAMD, HAMA得分都显著下降，RBANS各项得分则显著提高。研究三发现dTMS干预显著调节患者的TMS诱发电位N100振幅和P180振幅，且振幅变化与患者临床症状改善相关;患者TMS诱发电位多个特征值变化与认知功能、尤其是即时记忆功能改善显著相关。 结论:dTMS有效缓解抑郁症患者临床症状，改善认知功能。dTM S起效脑电机制涉及大脑兴奋和抑制机制调节，进而缓解抑郁症状、焦虑症状及认知损伤。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/46087]  |
| 专题 | 心理研究所_健康与遗传心理学研究室 |
| 推荐引用方式 GB/T 7714 | 李嘉欣. 深部经颅磁刺激改善抑郁症认知损伤及其脑电生理机制[D]. 中国科学院心理研究所. 中国科学院大学. 2023. |
入库方式： OAI收割
来源：心理研究所
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