| Object Depressive Disorder is a common and burden of mental illness,hard to completely cure,and accompanied by significant executive dysfunction.In recent years,domestic and foreign scholars have done a lot of research on the relationship between depression and executive dysfunction,but there are few researches on depression and response inhibition of sub-components of executive function.Repetitive transcranial magnetic stimulation?r TMS?is the most widely select brain stimulation technique with the advantage of noninvasive,safe,and can be used to treat disease by focusing magnetic pulses on the brain and stimulating nerve cells,approved by Food and drug administration?FDA?.In this study,reaction inhibition ability was taken as the entry point,carry out the treatment by the TMS instrument navigation system and the left DLPFC with the strongest connection to the nucleus accumbens function was used as the treatment target for individualized precise positioning.Behavioral paradigm and event-related potential were used to evaluate the response inhibition capacity of treatment-resistant depression and the therapeutic effect of its clinical symptoms.Methods In study one,In this study,29 depression patients and 30 healthy controls were enrolled.By combining the stop signal task with the event-related potential,to verify the Reaction inhibition disorder about treatment-resistant depression patients.In study two,A total of 47 depression patients were recruited in a double-blind study.They were randomly divided into a real group?23?and a sham group?21?.The real group received 10Hz excitatory r TMS intervention in the left dorsolateral prefrontal cortex with the strongest functional connection to the nucleus accumbens,while the sham group received the treatment with same parameter pseudo-stimulation for 15consecutive days.Before and after the intervention,all subjects were required to complete clinical symptom assessment,behavioral data collection and event-related potential data collection.Through the analysis of change before and after the intervention,the intervention effect of r TMS on depressive symptoms and response inhibition ability of depressed patients was evaluated.Result In study one,the results of the stop signal task showed that the SSRT of depression was longer than healthy group?t=4.786,P<0.05?,and depression patients had reaction inhibition disorder.The results of the signal detection theory analysis also revealed significant differences in the discrimination?t=5.507,P<0.05?and decision bias?t=7.479,P<0.01?between the depression group and the healthy group.The mean P3 amplitude of depression group was significantly lower than that of normal control group(F?1,57?=34.14,P<0.01).In study two,The interaction effect of HAMD scores before and after intervention between the real group and sham group was significant(F?1,42?=4.184,P<0.05).Further analysis of simple effects showed that the difference before and after r TMS in the real group was significantly greater than that in the sham group?t=2.05,P<0.05?.The results of repeated measures analysis of variance show that the pre-post difference of stop ACC,go ACC,go RT,SSD between real and sham group were not significant.But the result of SSRT show significant interaction effect(F?1,42?=4.287,P<0.05),the results of simple effect analysis showed that the pre-post difference of real group was significant?t=2.22,P<0.05?,while the sham group was not significant.The interaction effect of pre-post stop ACC,go ACC and SSD between the two groups was not significant.The results showed that the interaction effect between P3 average amplitude of stop task and two groups was significant(F?1,42?=6.65,P<0.05).The results of paired sample t test showed that the difference of pre-post P3 average amplitude in the real group was significant,while the difference of sham group was not significant.The results also showed that the interaction effect between P3 average amplitude of go task and two groups was not significant.Conclusion The response inhibition of depression was impaired.10hz-rtms intervention on the left DLPFC with the strongest connection to the nucleus accumbens can improve depressive symptoms and response inhibition in treatment-resistant depression,and the degree of improvement in depressive symptoms was associated with ability of response inhibition. |
PDF Full Text Request