高频重复经颅磁刺激对首发青少年抑郁症患者认知功能、冷执行功能及自杀意念的影响

摘要 目的：探讨高频重复经颅磁刺激（rTMS）对首发青少年抑郁症患者认知功能、冷执行功能及自杀意念的影响。方法：按照双色球法，将2020年10月~2022年11月期间南京医科大学附属脑科医院收治的114例首发青少年抑郁症患者分为对照组（富马酸喹硫平缓释片联合碳酸锂缓释片治疗，n=57）和观察组（对照组的基础上接受高频rTMS治疗，n=57）。对比两组临床疗效、抑郁症状、认知功能、冷执行功能、自杀意念和不良反应发生情况。结果：观察组的临床总有效率高于对照组（P<0.05）。两组治疗2周后、治疗4周后汉密尔顿抑郁量表-17（HAMD-17）评分下降，且观察组低于对照组同时间点（P<0.05）。两组治疗4周后蒙特利尔认知评估量表（MoCA）、听觉商数、注意力商数、视觉商数评分升高，且观察组高于对照组同时间点（P<0.05）；贝克自杀意念量表中文版评分（BSI-CV）下降，且观察组低于对照组（P<0.05）。两组不良反应总发生率组间对比未见明显差异（P>0.05）。结论：高频rTMS治疗首发青少年抑郁症患者，可有效改善患者的认知功能、冷执行功能，降低自杀意念，进一步缓解临床症状，安全性较好。

Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation on Cognitive Function, Cold Executive Function, and Suicidal Ideation in First-Episode Adolescent Depression Patients

ABSTRACT Objective: To explore the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) on cognitive function, cold executive function, and suicidal ideation in first-episode adolescent depression patients. Methods: According to the double color ball method, 114 first-episode adolescent depression patients admitted to the Brain Hospital affiliated to Nanjing Medical University from October 2020 to November 2022 were divided into the control group (treated with Quetiapine Fumarate Extended-Release Tablets and Lithium Carbonate Sustained-release Tablets, n=57) and the observation group (treated with high-frequency rTMS on the basis of the control group, n=57). Control group received quetiapine fumarate combined with lithium carbonate treatment, and observation group received high-frequency rTMS treatment on the basis of control group. The clinical efficacy, depression symptoms, cognitive function, cold executive function, suicidal ideation, and incidence of adverse reactions were compared between two groups. Results: The clinical total effective rate in observation group was higher than that in control group (P<0.05). The Hamilton depression scale-17 (HAMD-17) scores decreased in two groups 2 weeks after treatment and 4 weeks after treatment, and observation group was lower than that in control group at the same time point (P<0.05). The scores of Montreal cognitive assessment (MoCA), auditory quotient, attention quotient and visual quotient increased 4 weeks after treatment in two groups, and observation group were lower than those in control group at the same time point (P<0.05). The Chinese version of the Beck suicide intention scale (BSI-CV) scores decreased, and observation group was lower than that in control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between two groups (P>0.05). Conclusion: High-frequency rTMS treatment in first-episode adolescent depression patients, which can effectively improve patients'' cognitive function, cold executive function, and reduce suicidal ideation, further alleviate clinical symptoms, and good safety.