Effects of modified electroconvulsive therapy(MECT)or repetitive transcranial magnetic stimulation(rTMS)combined with clozapine respectively on memory and executive function in patients with refractory schizophrenia
Objective To investigate the effects of modified electroconvulsive therapy(MECT)or repetitive transcranial magnetic stimulation(rTMS)combined with clozapine on memory and executive function in patients with refractory schizophrenia(RS).Methods 98 patients with RS admitted to the hospital form December 2019 to December 2022 were selected and divided into MECT group and rTMS group by random number table method,with 49 cases in each group.The MECT group was given oral clozapine combined with MECT,and the rTMS group was given oral clozapine combined with rTMS,both treated for 8 weeks.The clinical efficacy of 2 groups and the scores of Positive and Negative Symptom Scale(PANSS),Wechsler Memory Scale(WMS)and Wisconsin Card Sorting Test(WCST)of 2 groups were compared be-fore,4 weeks and 8 weeks of treatment,and the adverse effects during treatment period were analyzed.Results There was no statistically significant difference in the total clinical efficiency between 2 groups(P>0.05).Compared with before the treatment,the positive symptoms score,negative symptoms score,general psychopathology score and total scores of PANSS were decreased in 2 groups after 4 and 8 weeks of the treatment,and the above scores after 8 weeks of thetreatment were lower than those after 4 weeks of the treatment(P<0.05).All the above PANSS scores were lower in MECT group than those in rTMS group after 4 weeks of the treatment(P<0.05).Compared with before the treatment,WMS scores in rTMS group after 4 and 8 weeks and MECT group after 8 weeks were increased,and the above scores after 8 weeks of the treatment were higher than those after 4 weeks(P<0.05).After 4 weeks of the treat-ment,WMS scores in MECT group were lower than those in rTMS group(P<0.05).Compared with be-fore thetreatment,the number of correct responses and completed classification of WCST in 4 and 8 weeks of the treatment were increased in both groups,and the number of correct responses and completed classi-fication after 8 weeks of treatment were higher than those after 4 weeks(P<0.05).Compared with be-fore the treatment,the number of WCST false response and sustained response were decreased in rTMS group at 4 and 8 weeks of the treatment and in MECT group at 8 weeks of the treatment,and the number of WCST false response and sustained response after 8 weeks of the treatment were lower than those after 4 weeks(P<0.05).The number of WCST false responses and sustained responses at 4 weeks in MECT group were higher than those in rTMS group(P<0.05).The incidence of adverse reactions in MECT group was 36.73%,which was higher than that in rTMS group(16.33%)(P<0.05).Conclusion MECT or rTMS combined with clozapine have the same effect in the treatment of RS patients,the former has a bet-ter effect on improving symptoms in the short term,while the latter has less effect on memory and execu-tive function in the short term,and it has fewer adverse reactions.
refractory schizophrenia(RS)modified electroconvulsive therapy(MECT)transcranial repetitive stimulationmemory functionexecutive function