经颅磁刺激联合舍曲林对有非自杀性自伤行为的抑郁症患者的认知水平、炎症反应和神经功能的影响

IF 1 4区 医学 Q4 NEUROSCIENCES
Actas espanolas de psiquiatria Pub Date : 2024-02-01
Jun Liu, Juan Guan, Jie Xiong, Fang Wang
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引用次数: 0

摘要

背景介绍抑郁症是一种慢性精神疾病,其主要临床症状是持续的情绪低落。目前,临床上主要采用心理治疗和药物治疗,在一定程度上缓解了患者的负面情绪。然而,单纯依赖药物治疗对神经递质的影响具有滞后性,长期服用往往会产生恶心、嗜睡、便秘等不良副作用,严重影响了患者的服药依从性。本研究旨在探讨经颅磁刺激与舍曲林联合应用对有非自杀性自伤(NSSI)行为的抑郁症患者的认知水平、炎症反应和神经功能的影响:选取我院 2020 年 12 月至 2023 年 2 月收治的 130 例有非自杀自伤行为的抑郁症患者作为研究对象。单一组(65 例)接受盐酸舍曲林口服片治疗,联合组(65 例)在接受舍曲林治疗的同时接受重复经颅磁刺激(rTMS)治疗。两组患者均使用神经心理状态评估可重复电池(RBANS)评估抑郁状态和认知功能水平。此外,还采用酶联免疫吸附试验(ELISA)测定血清中的炎症因子水平,包括肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)。此外,还评估了血清中神经递质(去甲肾上腺素(NE)、多巴胺(DA)、5-羟色胺(5-HT))和神经细胞因子(脑源性神经营养因子(BDNF)、神经生长因子(NGF)、神经胶质纤维酸性蛋白(GFAP))的水平。然后评估了两组干预措施的临床效果:治疗后,联合组的即时记忆、延迟记忆、注意力、视觉功能和语言功能水平明显高于单一组,差异有统计学意义(P < 0.05)。此外,联合组的血清 TNF-α、IL-1β、IL-6 和 GFAP 水平低于单一组,而联合组的 BDNF 和 NGF 水平高于单一组,差异有统计学意义(P < 0.05)。这些差异也具有统计学意义(P < 0.05)。同时,联合组的临床总有效率达到了 95.38%,超过了单一组的 84.61%,两组之间的差异有统计学意义(P < 0.05):经颅磁刺激与舍曲林联合用于治疗表现出 NSSI 行为的抑郁症患者,在增强患者认知功能、减轻炎症反应、提高神经递质和神经细胞因子水平方面被证明是有效的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of Transcranial Magnetic Stimulation Combined with Sertraline on Cognitive Level, Inflammatory Response and Neurological Function in Depressive Disorder Patients with Non-suicidal Self-injury Behavior.

Background: Depressive disorder is a chronic mental illness characterized by persistent low mood as its primary clinical symptom. Currently, psychotherapy and drug therapy stand as the primary treatment modalities in clinical practice, offering a certain degree of relief from negative emotions for patients. Nevertheless, sole reliance on drug therapy exhibits a delayed impact on neurotransmitters, and long-term usage often results in adverse side effects such as nausea, drowsiness, and constipation, significantly impeding medication adherence. This study aims to investigate the impact of combining transcranial magnetic stimulation with sertraline on the cognitive level, inflammatory response, and neurological function in patients with depressive disorder who engage in non-suicidal self-injury (NSSI) behavior.

Methods: A total of 130 depressive patients NSSI behavior, who were admitted to our hospital from December 2020 to February 2023, were selected as the subjects for this research. The single-group (65 cases) received treatment with oral sertraline hydrochloride tablets, while the combination group (65 cases) underwent repetitive transcranial magnetic stimulation (rTMS) in conjunction with sertraline. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was utilized to assess the depression status and cognitive function levels of both groups. Additionally, the enzyme-linked immunosorbent assay (ELISA) was employed to measure serum levels of inflammatory factors, including tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6). Furthermore, serum levels of neurotransmitters (norepinephrine (NE), dopamine (DA), 5-hydroxytryptamine (5-HT)) and neuro-cytokines (brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), glial fibrillary acidic protein (GFAP)) were assessed. The clinical effects of the interventions on both groups were then evaluated.

Results: Following the treatment, the combination group exhibited significantly higher levels of immediate memory, delayed memory, attention, visual function, and language function compared to the single group, with statistically significant differences (p < 0.05). Additionally, the serum levels of TNF-α, IL-1β, IL-6, and GFAP in the combination group were lower than those in the single group, while the levels of BDNF and NGF were higher in the combination group compared to the single group. These differences were also statistically significant (p < 0.05). Simultaneously, the total clinical effective rate in the combination group reached 95.38%, surpassing the 84.61% observed in the single group, and the disparity between the two groups was statistically significant (p < 0.05).

Conclusions: The combined use of rTMS and sertraline in treating patients with depressive disorder exhibiting NSSI behavior has proven to be effective in enhancing cognitive function, mitigating inflammatory responses, and elevating levels of neurotransmitters and nerve cytokines in the patients.

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来源期刊
Actas espanolas de psiquiatria
Actas espanolas de psiquiatria 医学-精神病学
CiteScore
1.70
自引率
6.70%
发文量
46
审稿时长
>12 weeks
期刊介绍: Actas Españolas de Psiquiatría publicará de manera preferente trabajos relacionados con investigación clínica en el área de la Psiquiatría, la Psicología Clínica y la Salud Mental.
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