抑郁症患者运动阈值研究.docVIP

抑郁症患者运动阈值研究 　　【摘要】 目的 了解抑郁症患者的运动阈值(motor threshold，MT)与正常人的差异，探讨抑郁症患者的皮层兴奋性变化。方法 用单脉冲经颅磁刺激(single-pulse Transcranial Magnetic Stimulation，sTMS)检测均为右利手的21例抑郁症患者和21例正常对照的MT值。结果 抑郁症患者的MT值左侧高于右侧，正常对照的MT值为左侧低于右侧；抑郁症患者左侧的MT值显著高于正常对照(t=2.24，P0.05)；抑郁症患者右侧的MT值随着病程的增长而增加(r=0.46，P0.05)。结论 抑郁症患者的皮层兴奋性与正常对照存在差异，具体表现为抑郁症患者左、右两侧皮层兴奋性的不对称性与正常对照呈相反表现；抑郁症患者左侧大脑皮层的兴奋性明显降低。 　　【关键词】 抑郁症；经颅磁刺激；运动阈值；皮层兴奋性 　　 　　The Research on Motor Threshold of Patients with Depression. Cui Xuelian, Zhang Liyi, Gao Zhiqin, et al. The Second Military Medical University, Shanghai 200433, P.R.China 　　【Abstract】 Objective To investigate the difference of motor threshold(MT) between the depressed patients and normal volunteers, and analyze the change of cortical excitability in patients. Methods 21 right-handed patients with depressive disorder and 21 right-handed healthy control subjects were detected the MT using single-pulse Transcranial Magnetic Stimulation (sTMS). Results Patients MT in left are higher than those in right, and they are reverse in normal controls; Compared with the controls, the left MT in depressive patients increase significantly(t=-2.24, P0.05); There is a positive correlation between the right MT in depression and the course of disease (r=0.46, P0.05). Conclusion The interhemispheric asymmetries of brain motor cortical excitability in patients with depressive disorder are opposite to the controls, and the left cortical excitability in patients have a evident decrease relative to normal subjects. 　　【Key words】 Depression; Transcranial magnetic stimulation; Motor threshold; Cortical excitability 　　 　　经颅磁刺激(Transcranial Magnetic Stimulation，TMS)是1985年由Barker[1]首先创立，它可以无创性的直接研究运动皮层的兴奋性。本研究将用单脉冲经颅磁刺激(sTMS)作为研究工具检测抑郁症患者的运动阈值(MT)，以了解抑郁症患者运动皮层的兴奋性。 　　 　　1 对象与方法 　　 　　1.1 研究对象 　　1.1.1 抑郁症组 共21例，为2006年7月至2007年1月在我院连续住院的患者，均符合中国精神障碍与诊断标准第3版(CCMD-3)的抑郁症诊断标准、24项汉密顿抑郁量表前17项总分≥18分。无药物和酒精滥用史，无癫痫、脑外伤等神经系统疾病，患者测量前至少4周内未服用任何抗抑郁药物、抗癫痫药、情绪稳定剂或苯二氮卓类药物，且均为经过爱丁堡左右手量表(Edinburgh Handedness Scale，E