Study On The Executive Function And Efficacy Of Deep Transcranial Magnetic Stimulation Combined With Fluvoxamine In Different TCM Syndrome Types Of Obsessive-compulsive Disorde

Objective:This study aims to analyze the differences in executive function,particularly cognitive flexibility,between patients with obsessive-compulsive disorder(OCD)and a healthy control group.Additionally,it aims to evaluate the correlation between the severity of OCD symptoms and impaired executive function.Furthermore,the study explores whether there are differences in treatment sensitivity to deep transcranial magnetic stimulation(deepTMS)combined with medication among OCD patients with different Traditional Chinese Medicine(TCM)patterns,providing further empirical data for the integrated treatment of OCD using both Western and Chinese medicine approaches.Methods:In this study,68 patients with OCD from October 2022 to May 2023 were collected from the outpatient and inpatient departments of the Department of Psychiatry,Hunan Brain Hospital.68 patients with OCD completed the DEX scale and the Y-BOCS scale,17 healthy controls were openly recruited from the community to set up the healthy group(HC group),and 20 of 68 patients with OCD were set up as the OCD group,and were classified into pure deficiency without reality group(n=10)and deficiency-reality combination group(n=10)by TCM identification and participated in the deepTMS intervention experiment.The HC and OCD groups completed Stroop Word-Color Test、Wisconsin Card Test(WCST)and Beck Depression Inventory(BDI)and Beck Anxiety Inventory(BAI)before and after the intervention;the data were collected and organized using Microsoft EXCEL 16.73,and the SPSS 27.0.0 statistical package was used for statistical and analysis to compare Whether there were differences in general demographic information between the HC and OCD groups,correlation between the DEX scale and the Y-BOCS scale,whether there were differences in cognitive flexibility between the HC and OCD groups,and whether the sensitivity of different TCM evidence types to deepTMS treatment was the same in the OCD group.Results:Of the 68 patients with OCD,scores on the Executive Dysfunction Scale and the Obsessive Compulsive Symptom Scale showed a statistically positive correlation(p<0.0 5),with no significant differences between the general demographic information of the HC and OCD groups(p>0.05);performance on the Stroop Word-Color Test and the Wisconsin Card Test in the HC group was significantly different from that of the OCD group(p<0.05),and the HC group performed better than the OCD group;there was a significant difference in the total score of compulsion in the pure deficiency without reality group after the deepTMS intervention compared to the pre-intervention(t=3.269,p<0.05),and there was a significant decrease in the total score of compulsion after the intervention,and there was no significant difference in the total score of compulsion in the deficiency-reality combination group after the deepTMS intervention compared to the pre-intervention(t=1.959,p>0.05),BDI scores in both groups showed significant differences after the intervention(p<0.05 for the pure deficiency without reality group and p<0.05 for the deficiency-reality combination group),and BAI scores in the pure deficiency without reality group showed significant differences after the intervention(p<0.05).Conclusion:The degree of executive function impairment was higher in patients with OCD than in healthy people,and there was a positive correlation between executive function and the severity of obsessivecompulsive symptoms;the higher the degree of executive function impairment,the more severe the obsessive-compulsive symptoms;deepTMS could improve patients’ cognitive flexibility while relieving obsessive-compulsive symptoms;patients with pure deficiency without reality OCD were more sensitive to deepTMS treatment than those with deficiency-reality combination group.