| BackgroundDepression is a serious mental disease affecting human health,its pathogenesis is not very clear,may be related to neuroendocrine,biochemical,genetic,cognitive,psychological and social factors etc.As one of the reasons for the onset of cognitive factors,the consensus is that there is a negative cognitive bias in patients with depression.Repetitive transcranial magnetic stimulation(repetitive transcranial magnetic stimulation,rTMS)is a physical therapy of treating mental disorders,so it is worthy of discussion on the effect of depression and negative cognitive bias.ObjectiveTo investigate the effect of rTMS curative patients with depression and influence on the core target that negative cognitive bias in the depression patient.Methods71 patients with first-episode depression were randomly divided into two groups by randomized controlled study.The study group(36cases)was treated with SNRIs antidepressant(venlafaxine hydrochloride sustained-release tablets)combined with rTMS.The control group(35cases)were treated with SNRIs antidepressant(venlafaxine hydrochloride sustained release tablets)combined with repetitive transcranial magnetic stimulation pseudo stimulation.The site selection of rTMS is left dorsolateral prefrontal cortex,placing method by 10/20 international standard EEG electrodes,selection of F3,treatment of brain center of the coil was placed in the left dorsolateral prefrontal cortex corresponding to stimulus frequency 10 HZ,stimulus intensity 100%MT,each time for 20 minutes.In the control group,the coil was placed at 90 degrees against scalp and the other parameters were consistent with the study group.On admission second days for first times,5 d weekly,for 5 times,interrupt 2 days,continuous treatment for 4 weeks,a total of 20 times.Using the HAMD assessment of clinical symptoms in patients with depression,with HAMD lower than 8 is recovered,the reduction rate of HAMD is more than 50% effective.The negative cognitive bias was assessed by the negative cognitive processing bias questionnaire and the change of response time under the visual search paradigm,and the change of response time is compared with the 30 normal group.Patients were assessed with symptom scale(TESS)at the time of treatment.The efficacy,safety and negative cognitive bias of the study group and the control group were compared.SPSS18.0 statistical software was used to analyze the data by independent sample t test,chi square test and variance analysis.The data were statistically significant with P<0.05.Results1 There was no significant difference(P>0.05)in the age,gender,education level of the basic data among the study group,the control group,the normal group.It has no significant difference between the study group and the control group in the course of disease and drug dose(P>0.05).2 The difference of the HAMD score between the study group and control group before treatment was no significance(t=0.424,P>0.05).There was significant difference between the two groups in the HAMD score at the end of the 2 week(t=3.085,P<0.05),there was statistical significance(t=4.919,P<0.05)in the difference of the HAMD score at the end of 4 week between the study group and control group.The difference of the HAMD score of the study group before treatment and after 2 weeks treatment was statistically significant(t=3.451,P<0.05)compared with the control group.3 In the study group and the control group,after 2 weeks treatment,the marked improvement rate of study group were 66.67%(24/36),the cure rate was 38.88%(14/36),the marked improvement rate of the control group were 40%(14/35),the cure rate was 28.57%(10/35),the marked improvement rate between the two group was statistically significant(c2=5.073,P<0.05),the cure rate between the two groups was not statistically significant(c2=0.844,P>0.05);After 4 weeks of treatment,the marked improvement rate of the study group was 91.66%(33/36),the marked improvement rate of the control group was 57.14%(20/35),the marked improvement rate between the two groups has a statistically significant difference(c2=5.844,P<0.05).After the 4 week of treatment,the cure rate of the study group was 83.33%(30/36),the cure rate of the control group was 57.14%(20/35),two groups in cure rate was statistically significant(c2=5.844,P<0.05).4 No patient is out of treatment,no serious adverse reactions happened in the treatment.In the study group and the control group the incidence of adverse reactions has no significant difference(c2=0.097,P>0.05)by the chi square test.The rate of the two groups combined with two benzodiazepines proportion has no significant difference(c2=0.339,P>0.05)by the chi square test.5 The scores of the negative cognitive processing bias in the study group and the control group were higher than those in the normal group not only at the time of admission but also at the end of the 4 week(P<0.05).There was significant difference in the study group in the negative cognitive processing bias scores(P<0.05),and the difference was statistically significant for the study group before and after 4 weeks treatment(P<0.05).There was significant difference of the control group in the negative cognitive processing bias scores(P<0.05),the difference of the control group before treatment and after 4 week treatment was statistically significant(P<0.05).The difference of the scores of the negative cognitive processing bias of the study group at the end of the 2 week compared with the admission were higher than that of the control group(P<0.05).At the end of the 4 week,the scores of negative cognitive processing bias in the study group were lower than those in the control group(P<0.05).6 In the sad face environment of visual search target stimuli,the difference between the response of the study group and the control group was no significant difference(P>0.05),the reaction time of the two groups was higher than the normal group(P<0.05).At the end of the 4 week treatment,the response time of the study group and the control group was lower than the response time of the two group before treatment(P<0.05).At the end of the 4 week treatment,the response time of the study group was lower than the response time of the control group(P<0.05),but compared with the normal group,the response of the study group was no significant difference(P>0.05).There was no difference between the response time of control group and normal group at the end of 4week(P<0.05).Conclusion1 rTMS combined with antidepressants in treatment of depression,compared with the single antidepressant therapy,can improve the clinical symptoms of patients with depression earlier,more effective treatment to improve the efficiency of depression.2 There was significant negative cognitive bias in patients with depression;3 rTMS combined with antidepressant treatment,compared with the single use of antidepressant drugs,can improve the negative cognitive bias earlierly and betterly in patients with depression. |
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