Effects Of RTMS Combined With Fluoxetine On The Efficacy And Cognitive Function Of Patients With Depression

Backgrounds Depression is a threat to global health and safety issues,which has brought a heavy burden to the community and the family.The current focus of depression treatment is to improve the patient's mood symptops.However their cognitive dysfunction is often overlooked.Several studies report that Fluoxetine,rTMS can improve the cognitive function of depressed patients at a certain extent.Depression with improvement cognitive function in patients with depression is facilated to recover their social function.Objective To investigate the effect of low frequency rTMS combined with fluoxetine on the efficacy and cognitive function of patients with depression.Methods60 depression patients for the study from Second People's Hospital of Shangqiu City were randomly divided into research group(30 cases)and control group(30 cases).Two groups of patients were treated with fluoxetine conventional treatment,20-40mg/d.Combined with real rTMS stimulation basis on fluoxetine treatment,with 80% of the stimulation intensity on the right dorsolateral prefrontal of the patients,at a frequency of1 Hz,5 times a week continuous treatment for 6 weeks in research group.Control group was given a pseudo-stimulation treatment.All patients prior to enrollment(baseline),respectively,the Hamilton Depression Scale(HAMD)assessed after treatment for 2,4,6weeks.TO investigate the effects and cognitive function of rTMS combined with fluoxetine in patients with depression,the Montreal Cognitive Assessment(Mo CA)and event-relatedpotentials were used to assess cognitive function,TESS scale was applied to evaluate the adverse event.Results1.The clinical curative effect of depression After 6 weeks of treatment,6 cases were cured,11 cases were significant progress,7cases were progress,6 cases were invalid,total effective rate was 80.00%(24/30)in the research group.4 cases were cured,6 cases were significant progress,6cases were progress,13 cases were invalid,total effective rate was 55.17%(16/29)in the control group the total effective rate of research group was significantly higher than that in control group(c2=4.163,P<0.05);The HAMD scores at baseline and treatment for 2 weeks,4weeks and 6 weeks were(28.83±3.03),(21.07±2.45),(15.07±2.27),(10.50±2.43)orderly in research group.The HAMD scores at baseline and treatment for 2 weeks,4 weeks and 6weeks were(29.21±3.83),(22.66±2.70),(18.48±3.05),(13.86±2.03)respectively in control group.After treatment for 2,4,6 weeks,the HAMD scores at baseline in the two groups were significantly lower(F=287.393,P<0.05;F=135.312,P<0.05).Moreover,the HAMD scores after treatment for 2,4,6 weeks in research group were more significantly reduced than those in control group(t=-2.370,P<0.05;t=-4.883,P<0.05;t=-5.754,P<0.05).2.Assessment of cognitive function N2-PL,P3-PL,P3 Amp and Mo CA scores at baseline were(324.37±40.15)ms,(382.20±20.60)ms,(5.07±1.23)?v,(17.27±1.46)respectively in research group.However,these scores after treatment for 6 weeks were(247.20±23.43)ms,(296.57±16.39)ms,(10.37±1.52)?v,(22.50±1.25).N2-PL,P3-PL,P3 Amp and Mo CA scores at baseline were(326.10±43.52)ms,(378.34±20.72)ms,(5.03±1.21),(17.45±1.53)orderly in the control group.However,these scores after treatment for 6 weeks were(279.38±31.58)ms,(338.34±18.36)ms,(7.65±1.08)?v,(21.52±2.23)..The scores of N2-PL,P3-PL and Mo CA were significantly lower in research group than those at baseline(t=9.092,P<0.05;t=17.817,P<0.05;t=-14.904,P<0.05),but the scores of P3 Amp after treatment for 6weeks were significantly higher than that at baseline(t=-14.846,P<0.05).The scores of N2-PL,P3-PL,Mo CA after treatment for 6 weeks in research group significantly reduced compared with those in control group(t=4.679,P<0.05;t=7.781,P<0.05;t=-8.104,P<0.05).However,the scores of P3 Amp increased more than those in control group(t=-8.699,P<0.05).3.Clinical adverse reactions The occurrence of adverse reactions was 33.33%(10/30)in research group,31.03%(9/29)in the control group.The incidence of adverse reactions was no significant difference in two groups(c2=0.036,P>0.05).And TESS scores were also no significant difference(t=0.073,P>0.05;t=-0.165,P>0.05;t=0.196,P>0.05).Conclusion Low frequency rTMS combined with fluoxetine in the treatment of depression has more significant effect,better security and fewer adverse reactions,which can significantly improve cognitive function of patients with depression..