经颅磁刺激对失眠人群的自主神经功能的影响

The Effect of Transcranial Magnetic Stimulation on Autonomic Nervous System Function in Insomnia Patients

摘要: 目的：探讨经颅磁刺激(TMS)治疗对不同失眠时长患者自主神经功能的影响。方法：2023年7月~2024年7月，在重庆医科大学附属永川医院筛选符合失眠诊断的患者50名，按照失眠时长分为慢性失眠组(即失眠时长 ≥ 3个月，n = 27)和短期失眠组(即失眠时长<3个月，n = 23)。两组人员均接受经颅磁刺激治疗。比较两组的基本资料和观察指标[治疗前后的匹兹堡睡眠质量量表(PSQI)、植物神经电位(SSR)的潜伏期和波幅]。结果：两组基线资料比较，均无统计学意义(p > 0.05)。与治疗前相比，慢性失眠组治疗后PSQI、植物神经SSR潜伏期(p < 0.05)差异有统计学意义。波幅未见明显统计学差异(p > 0.05)。短期组治疗后PSQI (p < 0.05)及植物神经SSR潜伏期(p > 0.05)差异同样有统计学意义。两组之间PSQI (p > 0.05)、SSR (p > 0.05)未见显著统计学差异。结论：两组治疗后的PSQI量表评分均较治疗前后显著下降SSR的波幅及潜伏期均有改善，即经颅磁刺激治疗对不同失眠时长的患者的自主神经功能均有一定疗效。

Abstract: Objective: To investigate the effect of transcranial magnetic stimulation (TMS) therapy on the autonomic nervous system function of patients with different durations of insomnia. Method: From July 2023 to July 2024, 50 patients who met the diagnosis of insomnia were screened at Yongchuan Hospital Affiliated to Chongqing Medical University. They were divided into chronic insomnia group (insomnia duration ≥ 3 months, n = 27) and short-term insomnia group (insomnia duration < 3 months, n = 23) according to the duration of insomnia. Both groups received transcranial magnetic stimulation therapy. The basic information and observation indicators of the two groups were compared, including the Pittsburgh Sleep Quality Index (PSQI) and the latency and amplitude of the sympathetic skin response (SSR) before and after treatment. Results: There was no significant difference in baseline data between the two groups (p > 0.05). Compared with before treatment, there was a significant difference in PSQI and autonomic nervous system SSR latency (p < 0.05) in the chronic insomnia group after treatment. There was no significant statistical difference in the amplitude (p > 0.05). There were also statistically significant differences in PSQI (p < 0.05) and the latency of SSR in the autonomic nervous system (p > 0.05) after treatment in the short-term group. There was no significant statistical difference in PSQI (p > 0.05) and SSR (p > 0.05) between the two groups. Conclusion: The PSQI scores in both groups after treatment were significantly lower than those before treatment, and the amplitude and latency of SSR were improved, indicating that transcranial magnetic stimulation therapy has a certain therapeutic effect on the autonomic nervous function of patients with different lengths of insomnia.