| BackgroundDepression is a common clinical mental disease, but its pathogenesis still unknown. With the development of imaging, the part of organic brain damage may exist in patients with depression, suggesting that the pathogenesis of depression may be associated with organic brain damage. MBP and NSE are sign of proteins in white matter demyelination and neuronal injury. Repetitive transcranial magnetic stimulation (repetitive transcranial magnetic stimulation, rTMS) is a new type of physical therapy, the mechanism of improve depressive symptoms is still not very clear, Whether through repair white matter demyelination or neuronal injury, worth exploring.Objective1. To learn the effect of rTMS onset time, cognitive function in treatment of patients with major depression;2. To study the effect of rTMS on plasma MBP and NSE in patients with depression, and to explore the mechanism of action of rTMS is associated with white matter or neuronal repair.Methods1. According to the American diagnostic statistical manual of mental disorders, fourth edition (DSM-IV) diagnostic criteria, depressive episode. The Hamilton depression rating scale (Hamilton-24) score20points or more into the group, there are67cases into the group, and divided into research group (rTMS+drug group)33and control group (simple drug group)34.30cases of healthy volunteers as the normal control group. 2. The Hamilton depression rating scale (Hamilton-24) to assess the patient’s symptoms and curative effect.3. The Event related P300(Event-related Potential P300) test and determination of Eye Movement (Exploratory Eye Movement EEM) as indicator used to evaluate cognitive function in patients.4. Serum MBP and NSE concentration was measured by ELSIA kit.Results1.Two groups of patients with depression HAMD score changes:First week of treatment, the difference was not statistically significant (P=0.359), after2,4weekend the study group HAMD scores were lower than the control group, the difference was statistically significant (P=0.007, P=0.04).1week of treatment, both groups reduced fraction of the difference was not statistically significant (P=0.059), Treatment group2,4weekend HAMD scores points rate are higher than the control group, the difference was statistically significant (P=0.002, P=0.003).2.The latency and amplitude of each event related potential P300:(1)P300latency:Before treatment study group and control group was longer than normal control group, the difference is statistically significant (P=0.04, P=0.03); Before treatment, the study group and the control group showed no significant difference incubation period (P=0.940); After4weeks of treatment, the study group and the control group than before treatment to shorten the incubation period, but the study group before and after treatment difference was statistically significant (P=0.001),the control group before and after treatment showed no significant difference (P=0.123); Study group compared with the control group was significantly (P=0.007).(2)P300amplitude:Before treatment, the study group and the control group significantly lower than that in the control group, the difference was statistically significant (P=0.04, P=0.03); Before treatment, the study group and the control group showed no significant difference amplitude (P=0.940); after4weeks treatment, study group and the control group increased amplitude than before treatment, but the study group before and after treatment difference was statistically significant (P=0.032), the control group before and after treatment showed no significant difference(P=0.0651), the study group compared with the control group was significantly (P=0.044). 3. Each group of exploratory eye movement measurement (EEM) changes in NEF and RSS(1)NEF changes in each group before and after treatment:Before treatment, the study group and the control group were lower than normal control group on NEF, the difference was statistically significant (.P=0.000); Before treatment, the study group and the control group showed no significant difference compared to NEF(P=0.399); After4weeks of treatment, the study group and the control group NEF higher than before treatment, but the study group before and after treatment difference was statistically significant (P=0.032), Although the control group compared with before treatment NEF has increased, but no significant difference before and after treatment (.P=0.376); after4weeks of treatment, the study group compared with the control group, the difference was statistically significant (P=0.006).(2)Change of RSS before and after the treatment in each group:Before treatment, the study group and the control group RSS were lower than the normal control group, the difference was statistically significant (.P=0.047); treatment before the study group and the control group RSS difference was not statistically significant (P=0.251); After4weeks of treatment, RSS study group and the control group increased than before treatment, but the study group before and after treatment difference was statistically significant (P=0.012), while the control group before and after treatment showed no significant difference (P=0.762); After4weeks of treatment, the study group and the control group RSS difference was not statistically significant (P=0.260).4. MBP and NSE concentration changes:Different treatment time MBP and NSE concentration change value comparison (value=before concentration-different time point concentration treatment):MBP decline in the2and4weekend magnitude larger study group changes, compared with the control group, the difference was statistically significant (P=0.035, P=0.035); And NSE decreased in2and4weekend,no statistically significant differences between the two groups (P=0.491,P=0.319).Conclusions1.rTMS auxiliary paroxetine hydrochloride tablets in the treatment of depression, can improve patients with early treatment; 2.rTMS auxiliary paroxetine hydrochloride tablets in the treatment of depression, can improve the cognitive function;3. rTMS auxiliary paroxetine hydrochloride tablets in the treatment of depression, a greater degree than a simple drug can reduce plasma concentrations of MBP, rTMS may play a role in the process of white matter repair tips. |
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