| Objective: To analyze the early efficacy of the ultra-low frequencytranscranial magnetic stimulation combined with paroxetine in the treatmentof patients with first episode of depression and its impact on cognitivefunction and neurotransmitter function, to provide a scientific basis for theclinical application of ultra-low frequency transcranial magnetic stimulation.Methods: The first episode of depression in70patients were selectedfrom the outpatient and inpatient department of the Mental Health Center ofSichuan Province.Dividing all patients into combined treatment group anddrug group each have35cases by the way of fully digital randomize andgiven them4-week treatment.1time/day of ultra-low frequency transcranialmagnetic stimulation(14consecutive days) is applied to the combinedtreatment group in the first two weeks, Continued time is30min,stimulationintensity is500GS,circular coil to the whole brain magnetic field isapplied,Coil diameter is25cm,the distance on scalp is1.5-2.0cm,and takingparoxetine(20-40mg/day).Drug treatment group received sham stimulationand paroxetine(20-40mg/day).Two weeks later, the two groups of subjectswere receiving paroxetine. Adjustment of drug dose was based on the severityof the clinical symptoms and side effects.Given patients alprazolam0.4-0.8mg who taken insomnia.Guiding all subjects completed the HamiltonDepression Rating Scale(Hamilton rating for Depression, HAMD)24versionand the Wisconsin Card Sorting Test(Wisconsin Card Sorting Test,WCST) and cancellation test(cancellation test,CT),encephalofluctuograph Figuredetection in the baseline,2weeks,4weeks.Observation of subjects during thestudy period whether adverse reactions,such as dizziness,headache,tinnitus.Using SPSS19.0to establish database and statisticalanalysis.Results:①The number of combined treatment group and the treatmentgroup can continue to participate in the study were32and34.The efficiencyof combined therapy group was40.6%(13/32) than the drug treatment group17.6%(6/34)(x2=4.246, P=0.039) in the second week. The efficiency of thecombination therapy group efficiency of71.9%(23/32) higher than the drugtreatment group38.2(13/34)(x2=7.542, P=0.006) in the fouth weeks. Theefficient of combined treatment group in the fouth week was higher than thatin the second week (x2=6.349,P=0.012),The efficient of the drug treatment inthe fouth week was not statistically significant compared to the secondweek(x2=3.579,P=0.059).②In the combined treatment group,completedcategories and correct answer of the second week in the WCST were higherthan the baseline(P<0.05or P<0.01),but no significant difference(P>0.05)were found in the second and fouth weeks;Cancellation rough score wasgradually rising trend in different time points(P<0.05or P<0.01).In the drugtreatment group,the completed categories and correct answer number of thesecond week was not not statistically significant compared to the baseline,butlower than the fouth week(P<0.01),Cancellation score of the second weekwas higher than baseline(P<0.05),no significance was found in the secondand fouth week(P>0.05).completed categories and correct answer andCancellation rough points and score of the combined treatment group werehigher than the drug treatment group in the second weeks(P<0.01or P<0.05),after controlling these differences completed categories and correctanswer and Cancellation score of combined treatment group were higher thanthe drug treatment group in the fouth week(P<0.05).③In the combinedtreatment group,The total power and relative power of the5-HT and NE totalpower were higher in the fouth week than in the second week(P<0.01orP<0.05); Gamma-GABA total power in the second week was higher than thebaseline(P<0.01),but the difference was not statistically significant(P>0.05)compared to the fouth week;each time point Glu total power was graduallyincreased(P<0.01);Ach total power in the fouth week was lower than in thesecond week(P<0.01); excitement and inhibition index in the fouth week washigher than baseline and the second week(P<0.01);entropy in the second islower than the baseline(P<0.01),but no significant difference was found thanin the fouth week(P>0.05).In the drug treatment group,NE relative power inthe fouth week was higher than in the baseline and the secondweeks(P<0.01);the relative power of the gamma-GABA in the second weekwas higher than in the baseline (P<0.05);but no significant difference wasfound in the fouth and second week(P>0.05);The excitement and inhibitionindex in the fouth week was higher than in the baseline and the secondweek(P<0.05).The combination therapy group compared to the drugtreatment group,the gamma-GABA total power of the combination therapygroup was lower than the drug treatment group at the baseline(P<0.05);5-HTtotal and relative power and NE total power of the combined treatment groupwere higher than the drug treatment group in the fouth week(P<0.05orP<0.01);Gamma-GABA total power and relative power and Glu total powerand relative power of the combined treatment group were higher than the drugtherapy group in the second and fouth week(P<0.05),but the entropy value of the combination therapy group was lower than the drug treatment group in thesecond and fouth week(P<0.01).④combined treatment group suffered fromdry mouth5(15.6%),Nausea4(12.6%);drug treatment group suffered from drymouth3(9%),Nausea6(18.2%).The adverse reaction of the two groups wasno significant difference (P>0.05).Conclusion:①The early efficacy of ultra-low frequency transcranialmagnetic stimulation combined with paroxetine in the treatment of firstepisode of depression patients was higher than paroxetine alone.②ultra-lowfrequency transcranial magnetic stimulation combined with paroxetine in theshort-term treatment of depression patients with first episode of the processcan improve the part of cognitive function of the subject.③ultra-low-frequency transcranial magnetic stimulation combined withparoxetine can increase the total power and relative power of Glu and GABA,and5-HT relative power and NE total power. |
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