文章摘要

经颅直流电刺激对精神分裂症患者认知功能、社会功能及神经营养因子的影响

作者: 1王鑫, 1李盛延, 1赵顺程, 2袁金艳
1 青海省第三人民医院精神科，西宁 810007
2 陕西省人民医院胸外科，西安 710068
通讯: 袁金艳 Email: 13700279532@163.com
DOI: 10.3978/j.issn.2095-6959.2022.06.021

摘要

目的：探究经颅直流电刺激(transcranial direct current stimulation，tDCS)对精神分裂症患者认知功能、社会功能及神经营养因子的影响。方法：选择2019年5月至2021年5月在青海省第三人民医院进行治疗的98例精神分裂症患者，随机分为观察组与对照组，每组49例。在常规抗精神病药物治疗基础上，观察组接受tDCS真刺激干预，对照组接受tDCS假刺激干预。观察2组临床疗效，对比2组阳性与阴性症状量表(Positive and Negative Symptom Scale，PANSS)评分、住院神经病患者社会功能评定量表(Scale of Social Function of Psychosis Inpatients，SSPI)评分、认知成套测验(MATRICS consensus cognitive battery，MCCB)评分，检测分析2组患者脑部神经递质[多巴胺(dopamine，DA)、5羟色胺(5-hydroxytryptamine，5-HT)]水平、神经营养因子[脑源性神经营养因子(brain-derived neurotrophic factor，BDNF)水平、胶质源性神经营养因子(glial cell line-derived neurotrophic factor，GDNF)]水平。结果：观察组临床总有效率为89.80%，高于对照组的71.43%(P<0.05)；治疗后，观察组PANSS量表各方面评分及总分均低于对照组(P<0.05)；治疗后，观察组MCCB、SSPI评分均高于对照组(P<0.05)；治疗后，观察组脑DA、5-HT水平及血清BDNF、GDNF水平均高于对照组；2组患者对tDCS干预的耐受性良好，均未出现严重不良事件，且2组刺痛感、皮肤发红等轻微不良事件发生率比较差异无统计学意义(P>0.05)。结论：tDCS治疗可提高精神分裂症患者临床疗效，缓解精神分裂症状，提高认知功能和社会功能，其作用机制可能与提高脑部神经递质水平和改善血清营养因子水平相关。
关键词： 经颅直流电刺激；精神分裂症；认知功能；社会功能；神经营养因子

Effects of transcranial direct current stimulation on cognitive function, social function and neurotrophic factors in patients with schizophrenia

Authors: 1WANG Xin, 1LI Shengyan, 1ZHAO Shuncheng, 2YUAN Jinyan
1 Department of Psychiatry, Qinghai Third People’s Hospital, Xining 810007, China
2 Department of Thoracic Surgery, Shaanxi Provincial People’s Hospital, Xi’an 710068, China

CorrespondingAuthor: YUAN Jinyan Email: 13700279532@163.com

DOI: 10.3978/j.issn.2095-6959.2022.06.021

Abstract

Objective: To investigate the effect of transcranial direct current stimulation (tDCS) combined with paliperidone on cognitive function, social function and neurotrophic factors in patients with schizophrenia. Methods: A total of 98 patients with schizophrenia treated in Qinghai Third People’s Hospital from May 2019 to May 2021 were randomly divided into an observation group and a control group, 49 cases in each group. On the basis of conventional antipsychotic treatment, the observation group received real tDCS intervention, and the control group received sham tDCS intervention. The clinical efficacy of the two groups was observed. The Positive and Negative Symptom Scale (PANSS) scores, Scale of Social Function in Psychosis Inpatients (SSPI) scores, and MATRICS Consensus Cognitive Battery (MCCB) scores were compared between the 2 groups. The levels of neurotransmitters [dopamine (DA), 5-hydroxytryptamine (5-HT)] and neurotrophic factors [serum brain-derived neurotrophic factor (BDNF), glial-derived neurotrophic factor (GDNF)] in the brain of the two groups were detected and analyzed. Results: The total effective rate of the observation group was 89.80%, which was higher than 71.43% of the control group (P<0.05). After treatment, the PANSS scores and total scores of the observation group were lower than those of the control group (P<0.05). After treatment, MCCB and SSPI scores in the observation group were higher than those in the control group (P<0.05). After treatment, the levels of brain DA and 5-HT, serum BDNF and GDNF in the observation group were higher than those in the control group. The patients in the two groups had good tolerance to tDCS intervention, and no serious adverse events occurred. There was no significant difference in the incidence of mild adverse events such as pain and skin redness between the 2 groups (P>0.05). Conclusion: tDCS combined with paliperidone can improve the clinical efficacy of patients with schizophrenia, alleviate the symptoms of schizophrenia, and improve cognitive function and social function. Its mechanism may be related to the improvement of brain neurotransmitter and the improvement of serum nutritional factor level.

Keywords： transcranial direct current stimulation; schizophrenia; cognitive function; social function; neurotrophic factors

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