摘要【目的】探讨经颅直流电刺激(Transcranial direct current stimulation,tDCS)对卒中后抑郁(Post-stroke depression,PSD)患者的疗效及谷氨酸(Glutamate,Glu)、5-羟色胺(5- hydroxytryptamine,5-HT)表达的影响。【方法】选取2016年10月至2017年5月本院收治的47例PSD患者为研究对象,随机分成观察组(24例)和对照组(23例)。观察组给予真性tDCS治疗,对照组给予假性tDCS治疗,疗程8周。分别于治疗前、治疗后7 d、14 d、8周,采用美国国立卫生研究院卒中评分 (National Institute of Health Stroke Scale,NIHSS)评定患者神经功能情况,采用汉密尔顿抑郁量表17项版本(the 17-item Hamilton Depression Rating scale,HDRS)和蒙哥马利抑郁量表(Montgomery and sberg Depression Rating Scale,MADRS)来评定患者的抑郁状态,采用用高效液相色谱-荧光检测法检测两组患者治疗前、后血浆Glu、5-HT的浓度。【结果】治疗前,两组NIHSS、HDRS、MADRS评分和血浆Glu、5-HT的浓度比较,差异无统计学意义(P>0.05);治疗8周后,观察组患者NIHSS、HDRS、MADRS评分显著下降,血浆5-HT水平升高、Glu下降,与对照组比较,差异有统计学意义(P<0.05)。【结论】tDCS可能通过对Glu、5-HT通路的调节对PSD患者起到较好地治疗作用。
Abstract：【Objective】To investigate the effect of transcranial direct current (tDCS) stimulation on poststroke depression (PSD) and the expression of 5-hydroxytryptamine (5-HT).【Methods】From October 2016 to May 2017, 47 patients with PSD were randomly divided into observation group (n=24) and control group (n=23). The observation group was treated with true tDCS and the control group with false tDCS for 8 weeks. Before treatment and 7 days , 14 days and 8 weeks after treatment, neurologic function was assessed by the National Institutes of Health Stroke score (NIHSS), The 17-item Hamilton Depression Rating scale (HDRS) and the Montgomery Depression scale ( MADRS) were used to assess depression in patients. High performance liquid chromatography (HPLC)-fluorescence assay was used to detect plasma Glu,5-HT levels in both groups before and after treatment.【Results】Before treatment, there was no significant difference in NIHSS,HDRS,MADRS score, plasma Glu and 5-HT concentration between the two groups (P>0.05). After 8 weeks of treatment, the NIHSS,HDRS,MADRS score of the patients in the observation group decreased significantly, and the plasma 5-HT level increased, while Glu decreased. The difference was statistically significant compared with that of the control group (P<0.05).【Conclusion】 TDCS may play a better role in the treatment of PSD patients by regulating the Glu and 5-HT pathway.
苏牟潇, 姚力英, 陈忠伦, 段劲峰. 经颅直流电刺激对卒中后抑郁患者的疗效及谷氨酸、5-羟色胺表达的影响[J]. 医学临床研究, 2018, 35(11): 2127-2129.
SU Mou-xiao, YAO Li-ying, CHEN Zhong-lun,et al. Effect of Transcranial Direct Current (tDCS) Stimulation on Post-stroke Depression (PSD) and the Expression of 5-Hydroxytryptamine (5-HT). JOURNAL OF CLINICAL RESEARCH, 2018, 35(11): 2127-2129.
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2018, Vol. 35 
