摘要

【摘要】
目的 观察经颅磁刺激（Transcranial Magnetic Stimulation, TMS）对抑郁症患者认知功能、血清脑源性神经营养因子（brain-derived neurotrophic factor，BDNF）、胰岛素样生长因子-1（Insulin-like growth factor 1，IGF-1）水平的影响。

方法 观察2024年1月至2025年1月我院抑郁症患者100例，按抽签分为观察组（n=50）对照组（n=50）。 对照组采用常规药物治疗，观察组在对照组的基础上使用rTMS治疗。比较两组患者疗效、抑郁情绪、认知功能、血清指标及不良反应。

结果 观察组疗效优于对照组（P＜0.05）；治疗后两组抑郁症状群量表-9（patient health questionnaires-9，PHQ-9）、汉密尔顿抑郁量表（Hamilton Depression Rating Scale ，HAMD）评分降低，观察组与对照组相比更低（P＜0.05）；治疗后两组蒙特利尔认知评估（Montreal Cognitive Assessment，MoCA）评分增加，观察组高于对照组（P＜0.05）；治疗后两组血清BDNF、IGF-1含量增加，观察组与对照组相比更高（P＜0.05）；两组不良反应基本相当（P＞0.05）。

结论 rTMS对抑郁症患者疗效显著，能够减轻抑郁情绪，提高认知功能及血清BDNF、IGF-1水平，且安全性良好。

关键词：【关键词】经颅磁刺激；抑郁症；认知功能；血清脑源性神经营养因子；胰岛素样生长因子-1

ABSTRACT

【Abstract】
Objective To investigate the effects of Transcranial Magnetic Stimulation (TMS) on cognitive function and serum levels of brain-derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1) in patients with depression.

Methods This prospective study enrolled a cohort of 100 inpatients with depression between January 2024 and January 2025. Participants were randomized using a lottery method into either an observation group or a control group, with 50 subjects per group. The control group was treated with conventional pharmacotherapy alone. In contrast, the observation group received the same conventional pharmacotherapy as the control group, supplemented with adjunctive repetitive transcranial magnetic stimulation (rTMS). Treatment efficacy, depressive symptoms, cognitive function, serum biomarker levels, and adverse reactions were compared between the two groups.

Results The observation group demonstrated superior clinical efficacy compared to the control group (P < 0.05). Although depressive symptoms decreased on both the PHQ-9 and HAMD in the two groups following the intervention, the observed reductions were significantly more pronounced in the observation group relative to the controls (P < 0.05). Scores on the Montreal Cognitive Assessment (MoCA) increased in both groups post-treatment, with significantly higher scores in the observation group compared to the control group (P < 0.05). Serum levels of BDNF and IGF-1 increased in both groups after treatment, with significantly higher levels in the observation group than in the control group (P < 0.05). The incidence of adverse events did not differ significantly between the two groups upon statistical analysis.(P > 0.05).

Conclusion   rTMS is a highly effective therapeutic intervention for patients with depression. It alleviates depressive symptoms, improves cognitive function, elevates serum BDNF and IGF-1 levels, and demonstrates a favorable safety profile.

Key words: 【Key words】Transcranial Magnetic Stimulation;Depression; Cognitive functionbrain-derived neurotrophic factor;Insulin-like growth factor 1