Treatment Of Repetitive Transcranial Magnetic Stimulation On Cognitive Inflexibility Of Obsessive-compulsive Disorder

Object Obsessive-compulsive disorder is a chronic disabling the heterogeneity of serious illness,its core is characterized by compulsive behavior or obsessive thoughts or both together.Numerous studies have shown that executive function by obsessive-compulsive disorder were impaired,and cognitive flexibility is one of the core characteristics of executive function,impaired of cognitive flexibility is the core of OCD cognitive impairment.Repetitive transcranial magnetic stimulation(r TMS)is a noninvasive,safe method of physical therapy by magnetic pulse to focus on related brain regions,stimulating the nerve cells to achieve the purpose of treating diseases.r TMS treatment of OCD is a hotspot of current research,but the effect and the mechanism is not clear.cognitive function in this The study chooses behavioral tests and event related potential,and 1HZ-r TMS targeted pre-supplementary motor area(pre-SMA)lasted 15 days to assist treatment effect of cognitive flexibility and its clinical symptoms.Methods In study one,using the Task Switch paradigm to assess cognitive flexibility,Thirty-two patients with obsessive-compulsive disorder(OCD)and Thirty-two healthy controls were included and were recorded by event-related potentials.In study two,Taking double-blind method,26 patients with obsessive-compulsive disorder were randomly divided into real r TMS group(13 cases)and sham r TMS group(13 cases),real group accepted 15 days treatment of 1 Hz inhibitory r TMS stimulation,concentrating on the pre-SMA,sham r TMS group received the same parameter setting,but no r TMS stimulation.From the perspective of behavioral science and event related potential,evaluated cognitive flexibility and clinical symptoms of patients before and aftertreatment.The cognitive flexibility was assessed by Task Switch paradigm,and the symptoms assessment was selected by the Yale-Brown Obsessive Compulsive Scale(Y-BOCS).Results In study one,In ACC,the OCD was lower than control group in the switch(P<0.05),and the repeat did not reach statistical significance(P > 0.05).In RT,the OCD compared with controls was significance in the repeat(P<0.05)and in the switch(P<0.00).In ERPs,The OCD of N2 amplitude(P < 0.05)and P3 amplitude(P=0.05)was significance compared with control.The OCD's cognitive flexibility and clinical forced symptoms were no statistical significance.In study two,In symptoms: Before and after treatment,the assessment of Y-BOCS in real group(P < 0.05)and sham group(P <0.001)were significance,the assessment of HAMD between real group(P < 0.05)and sham group(P<0.00)in treatment were significance,the assessment of HAMA in real group(P < 0.05)but sham group did not reach statistical significance(P > 0.05).In cognitive flexibility: In ACC and RT,the real group in the repeat(P < 0.05)and in the switch(P<0.05)was significance before and after treatment,but sham group did not reach statistical significance(P>0.05)in the repeat and in the switch before and after treatment.ERPs: Before and after treatment,there was no difference in electrode points of N2 amplitude and P3 amplitude.The clinical symptoms and OCD's cognitive flexibility were no statistical significance.Conclusion Obsessive-compulsive disorder of cognitive flexibility by injured.r TMS can improve cognitive flexibility in obsessive-compulsive disorders and have a better effect on clinical symptoms.