Abstract：Objective To investigate the effect of high-intensity repetitive transcranial magnetic stimulation (rTMS) on patients with major depression and suicidal ideation. Methods A total of 90 patients with major depression and suicidal ideation admitted in Ningbo Mental Hospital of Zhejiang Province from May 2018 to May 2021 were selected and divided into high-intensity group, routine group, and control group by random number table method, with 30 cases in each group. On the basis of oral Venlafaxine, the high-intensity group was treated with rTMS (twice a day), and the routine group was treated with rTMS (once a day), each treatment in both groups was 6 000 pulses, and the control group was treated with sham stimulation. The scores of Beck suicidal ideation scale Chinese version (BSI-CV) and Hamilton depression rating scale-24 items (HAMD-24) at different time points before and after treatment were observed. The occurrence of adverse reactions in the two groups was recorded. Results A total of seven cases fell off in this study, including three cases in the high-intensity group, two cases in the conventional group, and two cases in the control group. The BSI-CV scores at the end of the 3rd day of treatment in the high-intensity group and the routine group were lower than those before treatment, the BSI-CV scores of the three groups at the end of the 7th day of treatment were lower than those at the end of the 3rd day of treatment, and the BSI-CV scores of the three groups at the end of the 14th day of treatment were lower than those at the end of the seventh day of treatment (P ＜ 0.05). The BSI-CV scores of the high-intensity group at the end of the 3rd, 7th, and 14th day of treatment were lower than those of the routine group and the control group at the same time, the BSI-CV scores of the routine group at the end of the 3rd, 7th and 14th day of treatment were lower than those of the control group at the same time (P ＜ 0.05). The HAMD-24 scores of the three groups at the end of the 7th and 14th days of treatment were lower than those before treatment, and at the end of the 14th day of treatment were lower than those at the end of the 7th day of treatment (P ＜ 0.05). The HAMD-24 scores of the high-intensity group at the end of the 7th and 14th day of treatment were lower than those of the routine group and the control group at the same time, and the HAMD-24 scores of the routine group at the end of the 7th and 14th day of treatment were lower than those of the control group at the same time (P ＜ 0.05). The incidence of headache in high intensity group and routine group were higher than those in control group (P ＜ 0.017). Conclusion High-intensity rTMS treatment can quickly reduce the depressive symptoms and suicidal ideation in patients with major depression, and the effect is better than the conventional treatment once a day, which is a relatively safe treatment measure.
李松华 付可登 胡媛媛 王健美. 高强度重复经颅磁刺激治疗重度抑郁伴自杀意念患者的效果[J]. 中国医药导报, 2022, 19(26): 90-93.
LI Songhua FU Kedeng HU Yuanyuan WANG Jianmei. Effect of high-intensity repetitive transcranial magnetic stimulation on patients with major depression and suicidal ideation. 中国医药导报, 2022, 19(26): 90-93.
[1] 邹广顺，吕军城，董璐，等.中国城乡2002-2018年自杀死亡率发展趋势的Joinpoint回归分析[J].中国心理卫生杂志，2020，34（10）：828-833.
[2] 董佳妮，毕波，孔令韬，等.重性抑郁障碍患者自杀意念及其影响因素分析[J].中国神经精神疾病杂志，2018，44（8）：461-465.
[3] 胡玲玲，胡新伟，范洪峰，等.重复经颅磁刺激联合抗抑郁药对抑郁症首次发病患者的早期疗效及认知功能的影响[J].中国实用医药，2020，15（29）：127-129.
[4] 韩克艳，李宁，李天舒，等.重复经颅磁刺激对无抽搐电休克所致记忆损害抑郁症患者的效果研究[J].实用临床医药杂志，2021，25（7）：51-54.
[5] 秦碧勇，戴立磊，郑艳，等.重复经颅磁刺激对老年抑郁症患者临床症状及自杀意念的疗效[J].南方医科大学学报，2017，37（1）：97-101.
[6] 王琦，张云淑，董震，等.高频重复经颅磁刺激对抑郁症患者自杀意念和临床症状初期治疗的影响[J].中国健康心理学杂志，2021，29（10）：1468-1473.
[7] 付可登，李松华，胡媛媛，等.重复经颅磁刺激对抑郁症患者SSI评分的影响及治疗效果研究[J].中国医药导报，2020，17（16）：97-100.
[8] McGirr A，van den Eynde F，Tovar-Perdomo S，et al. Effectiveness and acceptability of accelerated repetitive transcranial magnetic stimulation （rTMS） for treatment-resistant major depressive disorder: an open label trial [J]. J Affect Disord，2015，173：216-220.
[9] George MS，Raman R，Benedek DM，et al. A two-site pilot randomized 3 day trial of high dose left prefrontal repetitive transcranial magnetic stimulation（rTMS） for suicidal inpatients [J]. Brain Stimul，2014，7（3）：421-431.
[10] Modirrousta M，Meek BP，Wikstrom SL. Efficacy of twice-daily vs once-daily sessions of repetitive transcranial magnetic stimulation in the treatment of major depressive disorder：a retrospective study [J]. Neuropsychiatr Dis Treat，2018，14：309-316.
[11] 朱俊娟，张天宏，张玲，等.高强度高频率重复经颅磁刺激对抑郁症自杀意念的疗效[J].上海交通大学学报（医学版），2019，39（5）：534-538.
[12] 肖茜，张道龙.ICD-11与DSM-5关于抑郁障碍诊断标准的异同[J].四川精神卫生，2019，32（6）：543-547.
[13] 马式意，李柄佑，王蕊，等.米氮平联合重复经颅磁刺激治疗缺血性脑卒中后抑郁的疗效观察[J].中华物理医学与康复杂志，2021，43（6）：520-522.
[14] 高骏波，肖筱，李云歌，等.低频重复经颅磁刺激影响青少年抑郁症自杀意念[J].中国临床心理学杂志，2021， 29（2）：424-428，435.
[15] 唐锴，叶庆红，易桂萍，等.阿戈美拉汀联合重复经颅磁刺激治疗老年惊恐障碍的临床研究[J].临床精神医学杂志，2021，31（5）：387-390.
[16] 王琦，杨松，张云淑，等.重复经颅磁刺激对伴有自杀观念抑郁症的治疗效果研究进展[J].大连医科大学学报，2019，41（4）：352-356.
[17] 荣悦彤，王晓明，周媛.非侵入性脑刺激技术在决策行为研究中的应用[J].中华行为医学与脑科学杂志，2019， 28（7）：666-670.
[18] 吕伟，李美花.不同频率重复经颅磁刺激对精神分裂症患者性激素水平及认知功能的影响[J].中国现代医学杂志，2020，30（12）：83-87.
[19] 彭薇，龚启勇，贾志云，等.难治性抑郁症非药物治疗新方法的神经影像学研究进展[J].中国医学影像学杂志，2018，26（7）：540-542，546.
[20] van Heeringen K，Mann JJ. The neurobiology of suicide [J]. Lancet Psychiatry，2014，1（1）：63-72.
[21] 张雄，姜蕊琪，祁冬冬，等.重复经颅磁刺激联合度洛西汀对抑郁症患者认知功能及神经递质水平的影响[J].国际精神病学杂志，2019，46（6）：1013-1015.
[22] Fitzgerald PB，Hoy KE，Reynolds J，et al. A pragmatic randomized controlled trial exploring the relationship between pulse number and response to repetitive transcranial magnetic stimulation treatment in depression [J]. Brain Stimul，2020，13（1）：145-152.
[23] 左成超，曹幻，王芙蓉，等.经颅磁刺激治疗抑郁症的研究进展[J].神经损伤与功能重建，2021，16（5）：270-273.
[24] 张玲，张天宏，魏燕燕，等.自杀意念的物理神经调控干预研究进展[J].上海交通大学学报（医学版），2019，39（6）：661-665.
[25] 胡晓月，潘伟刚，马辛，等.重复经颅磁刺激联合抗抑郁药治疗首次发病老年抑郁症的初步研究[J].中华精神科杂志，2021，54（4）：265-270.
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