重复经颅磁刺激干预对抑郁症患者海马结构及情绪调控能力的影响分析

Effects of repetitive transcranial magnetic stimulation on hippocampal structure and emotion regulation ability in patients with depression

摘要:

目的 探讨重复经颅磁刺激（rTMS）干预对抑郁症患者海马结构改变及情绪调控能力的影响。方法 选取2024年1月—2025年6月绍兴市第七人民医院收治的98例抑郁症患者作为研究对象，采用随机数字表法分为对照组（给予常规抗抑郁药物治疗）和观察组（在对照组基础上联合rTMS），各49例。比较两组患者的临床疗效、症状评分、血流灌注指标、情绪调控能力、海马体积及不良反应发生情况。结果 观察组总有效率高于对照组（P <0.05）。观察组治疗后汉密尔顿抑郁量表（HAMD-17）评分、平均通过时间（MTT）、表达抑制评分均低于对照组（P <0.05），治疗后脑血流量（CBF）、脑血容量（CBV）、认知重评评分、左侧海马体积、右侧海马体积及双侧海马体积均大于对照组（P <0.05）。观察组治疗前后HAMD-17评分、CBF、CBV、MTT、认知重评评分、表达抑制评分、左侧海马体积、右侧海马体积及双侧海马体积的差值均大于对照组（P <0.05）。观察组与对照组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 在常规抗抑郁治疗基础上联合rTMS干预可进一步改善抑郁症患者的抑郁症状和情绪调控能力，促进海马结构可塑性，且安全性良好，具有较高的临床应用价值。

Abstract:

Objective To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on hippocampal structural alterations and emotion regulation ability in patients with depression.Methods Between January 2024 and June 2025, 98 patients with depression in our hospital were enrolled and randomly assigned to a control group (n = 49), which received conventional antidepressant therapy, or an observation group (n = 49), which received rTMS in addition to conventional treatment. Clinical efficacy, symptom severity, cerebral perfusion parameters, emotion regulation ability, hippocampal volume, and adverse reactions were compared between the two groups.Results The overall effective rate was higher in the observation group than in the control group (P < 0.05). After treatment, the Hamilton Depression Rating Scale-17 items (HAMD-17) score was significantly lower in the observation group than in the control group (P < 0.05). The change in HAMD-17 score from baseline to post-treatment was significantly greater in the observation group than in the control group (P < 0.05). The changes in CBF, CBV, and MTT from baseline were also significantly greater in the observation group than in the control group (P < 0.05). After treatment, the cognitive reappraisal score was significantly higher and the expressive suppression score was significantly lower in the observation group than in the control group (P < 0.05). The changes in both scores from baseline were significantly greater in the observation group than in the control group (P < 0.05). After treatment, left, right, and bilateral hippocampal volumes were significantly higher in the observation group than in the control group (P < 0.05). The increases in hippocampal volumes from baseline were also significantly greater in the observation group than in the control group (P < 0.05). The overall incidence of adverse events showed no significant difference between the two groups (P > 0.05).Conclusion The addition of TMS to standard antidepressant therapy improves depressive symptoms and emotion regulation ability, enhances hippocampal structural plasticity, and is safe, supporting its clinical applicability.