| Objective:The incidence of anxiety/depression disorders is increasing in modern society,which seriously affects the work and quality of life of patients.Repetitive transcranial magnetic stimulation(r TMS)is a noninvasive,green form of physical therapy that stimulates areas of the brain to regulate brain metabolism and activity.A large number of studies have shown that TMS stimulates the corresponding brain area to produce excitement or inhibition effects,and regulates metabolism and neural electrical activity in the brain,thereby improving symptoms of anxiety and depression,but the specific regulation mechanism is not clear.In this study,patients with anxiety or depression disorder were treated with TMS,and we observed the changes of EEG before and after treatment,discuss the electrophysiological mechanism of TMS treating anxiety/depression disorder.Methods:Patients with anxiety and depression disorder who were treated at Second Affiliated Hospital of Dalian Medical University Hospital from October 2018 to October 2019 were evaluated by the Hamilton Anxiety Scale(HAMA)and the Hamilton Depression Scale(HAMD-17).15 patients with 14?HAMA?29 and HAMD?7 were selected into anxiety group,and 15 patients with 17?HAMD?24 and HAMA? 7were selected as the depression group.At the same time,15 healthy people which is age and gender-matched with HAMA?7,HAMD?7 were recruited as the control group.Electroencephalogram of the three groups was collected at the state of sobriety.The anxiety group was given 400 pulses of 5 Hz r TMS stimulation on the left DLPFC(dorsolateral prefrontal cortex)and 600 pulses of continuous theta burst stimulation(c TBS)on the right DLPFC;the depression group was given 1000 pulses of5 Hz r TMS on the left DLPFC,and the right DLPFC was stimulated with 400 pulses of c TBS,both were treated 20 times continuously.Patients in the anxiety group and depression group use SNRIs(serotonin and noradrenaline reuptake inhibitors)drugs simultaneously,except benzodiazepines.After the treatment,HAMA and HMD scores were performed again,and the EEG in the state of sobriety was collected.The clinical scale scores,EEG peak frequency of posterior region of head and power of all frequency band were compared before and after treatment.Results:1.There was no statistically significant difference in gender and age between anxiety group,depression group and control group(P> 0.05).2.Anxiety group vs.control group before and after treatment and before treatment vs.after treatment in anxiety group Compared with the control group before treatment,the anxiety group has higher HAMA scores(20.40±4.73 points and 5.20±1.15 points),and the difference was statistically significant(P<0.05);the peak frequency of posterior head is lower(9.08±0.62 Hz and10.03±0.31Hz),? power is lower(23.60±19.65?V2 and 37.75±11.96?V2),? power(7.02±3.64?V2 and 3.88±2.51?V2)is higher,? power is higher(2.48±1.12?V2 and1.62±0.84?V2),all the differences are statistically significant(P<0.05),and there was no statistically significant difference in ? power(P> 0.05).Compared with the control group after treatment,the anxiety group had higher HAMA scores(7.73±3.15 points and 5.20±1.15 points),the difference was statistically significant(P <0.05);the peak frequency of posterior head was lower(9.66±0.47 Hz and10.03±0.31).Hz),the difference is statistically significant(P <0.05),and there is no statistically significant difference in the power of each frequency band(P> 0.05).Pre-and post-treatment comparisons of anxiety group:the HAMA score decreased after treatment(7.73±3.15 points and 20.40±4.73 points),and the difference was statistically significant(P<0.05);the peak frequency of posterior head increased(9.66±0.470 Hz and9.08±0.624Hz),? power increased(26.07±20.13?V2 and 23.60±19.65?V2),? power decreased(2.58±1.93?V2 and 7.02±3.64?V2),? power decreased(1.16±0.44?V2and 2.48±1.20?V2),The differences were statistically significant(P <0.05),and the ?power differences were not statistically significant(P> 0.05).3.Depression group vs.control group before and after treatment and before treatment vs.after treatment in depression group Compared with the control group,the depression group has higher HAMD scores before treatment(19.73±2.46 points and 5.53±1.19 points);the peak frequency of posterior region of head was high(11.81±0.88 Hz and 10.03±0.31Hz),and the ? power was low(19.08±17.48?V2 Compared with 37.75±11.96?V2),? power was high(13.40±9.81?V2 and 6.82±5.30?V2),the differences were statistically significant(P <0.05),and there was no statistically significant difference between ? power and ? power(P> 0.05).Compared with the control group after treatment,the depression group had higher HAMD scores(8.27±1.58 points and 5.53±1.19 points),and the difference was statistically significant(P <0.05);the peak frequency was high(11.37±0.73 and10.03±0.31)The differences were statistically significant(P <0.05),and there was no statistically significant difference in the power of the remaining bands(P> 0.05).Pre-and post-treatment comparisons of anxiety group:the HAMD score decreased after treatment(8.27±1.58 points and 19.73±2.46 points),peak frequency of the posterior head decreased(11.37±0.73 Hz and 11.81±0.88Hz),and the ? power value increased(22.86±19.20?V2and 19.08±17.48?V2),? power value decreased(7.54±5.21?V2and 13.40±9.81?V2),the differences were statistically significant(P<0.05),and there was no statistically significant difference in ? power or ? power(P> 0.05).Conclusions:1.Patients with anxiety/depression have abnormal EEG activity.Slow waves increase in patients with anxiety disorder and fast waves increased in patients depression disorder.2.TMS reduces the slow wave in anxiety patients,decreases the fast wave in depression patients,and improves symptoms in patients with anxiety/depression,suggesting that TMS bidirectional regulation of EEG activity may be one of its treatment mechanisms. |
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