Efficacy evaluation of repeated transcranial magnetic stimulation combined with bipolar depression triple therapy in reducing female adolescents’ non-suicidal self-injury_Journal of Biomedical Engineering

Authors：

SHEN Yun ^1,2 , LI Jing ³ ,  ZOU Ke ¹ , YANG Kuanwei ² , SHU Yanping ² ,  ZHENG Zhong ^1,3

1. Center of Neurobioassay, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;
2. Women’s Mental Health Branch, Second People’s Hospital of Guizhou Province, Guiyang 550004, P. R. China;
3. Center of Neuroregulation and Detection, West China Xiamen Hospital of Sichuan University, Xiamen 361022, P. R. China;

Corresponding?author：

ZOU Ke, Email: keerdianer@163.com; ZHENG Zhong, Email: zhengzhong1963@163.com

Keywords：

Repetitive transcranial magnetic stimulation; Bipolar depression triple therapy; Non-suicidal self-injury in female adolescents

DOI：

10.7507/1001-5515.202411008

Video：

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In order to explore effective ways to reduce non-suicidal self-injury (NSSI) among female adolescents, a total of 45 female adolescent patients with NSSI in West China Hospital of Sichuan University and Guizhou Second Provincial People's Hospital from June 2021 to June 2024 were selected randomly that divided into groups A, B and C, with 15 cases in each group. Group A was treated with repeated transcranial magnetic stimulation (rTMS) and bipolar depression triple therapy, and group B was treated with bipolar depression triple therapy to compare the effectiveness and safety. Group C received bipolar depression triple therapy combined with sham stimulation which only produced stimulating sounds but no stimulating magnetic field as a control in the study. After treatment, the Hamilton Anxiety Score (HAMA), Hamilton Depression Score (HAMD) and Nurses’ Global Assessment of Suicide Risk (NGASR) in group A were significantly lower than those in group B and C (P < 0.01). rTMS combined with bipolar depression triple therapy has a definite effect on reducing NSSI in female adolescents, which can reduce the incidence rate of short-term NSSI behavior in patients.

Citation： SHEN Yun, LI Jing, ZOU Ke, YANG Kuanwei, SHU Yanping, ZHENG Zhong. Efficacy evaluation of repeated transcranial magnetic stimulation combined with bipolar depression triple therapy in reducing female adolescents’ non-suicidal self-injury. Journal of Biomedical Engineering, 2025, 42(2): 288-292. doi: 10.7507/1001-5515.202411008 Copy

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2.	陳錫美, 陳媛美, 陳蕓, 等. 青少年非自殺性自傷行為特征及高危因素分析. 中國醫學創新, 2024, 21(27): 157-161.
3.	姚珂珂, 司夏櫻. 非自殺性自傷青少年神經認知功能相關電生理研究進展. 中國當代兒科雜志, 2023, 25(6): 653-657.
4.	賈雪瑜, 王婷婷, 王春霞, 等. 非自殺性自傷行為與心理行為問題的研究進展. 神經疾病與精神衛生, 2023, 23(1): 2-6.
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6.	Koenig J, Rinnewitz L, Warth M, et al. Psychobiological response to pain in female adolescents with nonsuicidal selfinjury. J Psychiatry Neurosci, 2017, 42(3): 189-199.
7.	O’Reardon J P, Solvason H B, Janicak P G, et al. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry, 2007, 62(11): 1208-1216.
8.	何林麗, 蔡定均, 鄭博, 等. 電針配合重復經顱磁刺激治療焦慮抑郁共病的ERPs研究. 上海針灸雜志, 2012, 31(7): 461-463.
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10.	Hameed M Q, Dhamne S C, Gersner R, et al. Transcranial magnetic and direct current stimulation in children. Curr Neurol Neurosci Rep, 2017, 17(2): 11.
11.	蘇亮, 李茜, 于欣, 等, 齊拉西酮注射液超說明書用藥的中國專家共識. 臨床精神醫學雜志, 2021, 3(6): 425-429.
12.	張曉陽, 楊曉江, 王哲偉, 等. 齊拉西酮與氟哌啶醇注射液治療精神分裂癥急性激越癥狀的臨床對照研究. 四川精神衛生, 2015, 28(1): 42-44.
13.	Rosa A R, Franco C, Torrent C, et al. Ziprasidone in the treatment of affective disorders: a review. CNS Neurosci Ther, 2008, 14(4): 278-286.
14.	Ye Zhuofan, Zhang Fanshi, Cui Ruxue, et al. The effect of depression on non-suicidal self-injury and psychological status in adolescents with unipolar and bipolar disorders. BMC Psychol, 2024, 12(1): 743.
15.	Liu Jun, Guan Juan, Xiong Jie, et al. Effects of transcranial magnetic stimulation combined with sertraline on cognitive level, inflammatory response and neurological function in depressive disorder patients with non-suicidal self-injury behavior. Actas Esp Psiquiatr, 2024, 52(1): 28-36.
16.	王學義, 陸林. 經顱磁刺激與神經精神疾病. 北京: 北京大學醫學出版社, 2014: 112-118.
17.	Croarkin P E, Nakonezny P A, Husain M M, et al. Evidence for increased glutamatergic cortical facilitation in children and adolescents with major depressive disorder. JAMA Psychiatry, 2013, 70(3): 291-299.
18.	黃佳茜, 李涓, 鄒可, 等. 經顱磁刺激評估抑郁癥患者皮層興奮抑制性及其與癥狀嚴重程度的相關性. 精神醫學雜志, 2022, 35(1): 14-18.
19.	江山, 李婭娜, 王會會, 等. 低頻經顱磁刺激對缺血缺氧腦損傷大鼠學習記憶及體外培養缺血缺氧神經元谷氨酸釋放的影響. 中國康復醫學雜志, 2019, 34(12): 1397-1402.
20.	艾明, 靳佳佳, 冉柳毅, 等. 神經膠質高親和力谷氨酸轉運體基因多態性與青少年非自殺性自傷的關聯研究. 中華行為醫學與腦科學雜志, 2018, 27(3): 222-225.
21.	Darragh P D. The neuropathology of Self-Injurious Behavior: Studies using animal models. Brain Res, 2024, 1844(1): 149-172.
22.	Sun A Y, Woods S, Findling R L, et al. Safety considerations in the psychopharmacology of pediatric bipolar disorder. Expert Opin Drug Saf, 2019, 18(9): 777-794.
23.	Croarkin P E, MacMaster F P. Transcranial magnetic stimulation for adolescent depression. Child Adolesc Psychiatr Clin N Am, 2019, 28(1): 33-43.
24.	孫學禮. 精神病學第4版. 北京: 高等教育出版社, 2020: 197-207.
25.	孫亞男. 齊拉西酮聯合碳酸鋰治療青少年雙相I型障礙躁狂發作的療效評價. 中國現代藥物應用, 2021, 15(6): 209-211.
26.	陳燕. 齊拉西酮的研究進展. 國際精神病學雜志, 2015, 42(1): 138-140.
27.	Keck P E Jr, Versiani M, Potkin S, et al. Ziprasidone in the trearment of acute bipolar mania: a three-week, placebocontrolled, double-blind, randomized trial. Am J Psychiatry, 2003, 160(4): 741-748.
28.	Lakshmi N Y, Sidney H K, Sagar V P, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord, 2018, 20(2): 97-170.
29.	高駿波. 重復經顱磁刺激治療青少年抑郁癥非自殺性自傷研究進展. 中國健康心理學雜志, 2020, 28(11): 1738-1743.
30.	梁曉敏. 精神障礙住院患者自殺風險及其相關因素分析. 廣州: 廣州醫科大學, 2021.
31.	高赫, 童茂清, 樓忠澤, 等. 青少年雙相障礙門診患者非自殺性自傷行為的調查分析. 中國現代醫生, 2022, 60(15): 155-158.

1. 陸林. 沈漁邨精神病學第6版. 北京: 人民衛生出版社, 2018: 390-398.
2. 陳錫美, 陳媛美, 陳蕓, 等. 青少年非自殺性自傷行為特征及高危因素分析. 中國醫學創新, 2024, 21(27): 157-161.
3. 姚珂珂, 司夏櫻. 非自殺性自傷青少年神經認知功能相關電生理研究進展. 中國當代兒科雜志, 2023, 25(6): 653-657.
4. 賈雪瑜, 王婷婷, 王春霞, 等. 非自殺性自傷行為與心理行為問題的研究進展. 神經疾病與精神衛生, 2023, 23(1): 2-6.
5. Wolff J C, Thompson E, Thomas S A, et al. Emotion dysregulation and non-suicidal self-injury: a systematic review and meta-analysis. Eur Psychiatry, 2019(59): 25-36.
6. Koenig J, Rinnewitz L, Warth M, et al. Psychobiological response to pain in female adolescents with nonsuicidal selfinjury. J Psychiatry Neurosci, 2017, 42(3): 189-199.
7. O’Reardon J P, Solvason H B, Janicak P G, et al. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry, 2007, 62(11): 1208-1216.
8. 何林麗, 蔡定均, 鄭博, 等. 電針配合重復經顱磁刺激治療焦慮抑郁共病的ERPs研究. 上海針灸雜志, 2012, 31(7): 461-463.
9. Lefaucheur J P, Aleman A, Baeken C, et al. Evidence-based guidelines on the therapeutic use of repetitive transcranialmagnetic stimulation (rTMS): An update (2014-2018). Clin Neurophysiol, 2020, 131(2): 474-528.
10. Hameed M Q, Dhamne S C, Gersner R, et al. Transcranial magnetic and direct current stimulation in children. Curr Neurol Neurosci Rep, 2017, 17(2): 11.
11. 蘇亮, 李茜, 于欣, 等, 齊拉西酮注射液超說明書用藥的中國專家共識. 臨床精神醫學雜志, 2021, 3(6): 425-429.
12. 張曉陽, 楊曉江, 王哲偉, 等. 齊拉西酮與氟哌啶醇注射液治療精神分裂癥急性激越癥狀的臨床對照研究. 四川精神衛生, 2015, 28(1): 42-44.
13. Rosa A R, Franco C, Torrent C, et al. Ziprasidone in the treatment of affective disorders: a review. CNS Neurosci Ther, 2008, 14(4): 278-286.
14. Ye Zhuofan, Zhang Fanshi, Cui Ruxue, et al. The effect of depression on non-suicidal self-injury and psychological status in adolescents with unipolar and bipolar disorders. BMC Psychol, 2024, 12(1): 743.
15. Liu Jun, Guan Juan, Xiong Jie, et al. Effects of transcranial magnetic stimulation combined with sertraline on cognitive level, inflammatory response and neurological function in depressive disorder patients with non-suicidal self-injury behavior. Actas Esp Psiquiatr, 2024, 52(1): 28-36.
16. 王學義, 陸林. 經顱磁刺激與神經精神疾病. 北京: 北京大學醫學出版社, 2014: 112-118.
17. Croarkin P E, Nakonezny P A, Husain M M, et al. Evidence for increased glutamatergic cortical facilitation in children and adolescents with major depressive disorder. JAMA Psychiatry, 2013, 70(3): 291-299.
18. 黃佳茜, 李涓, 鄒可, 等. 經顱磁刺激評估抑郁癥患者皮層興奮抑制性及其與癥狀嚴重程度的相關性. 精神醫學雜志, 2022, 35(1): 14-18.
19. 江山, 李婭娜, 王會會, 等. 低頻經顱磁刺激對缺血缺氧腦損傷大鼠學習記憶及體外培養缺血缺氧神經元谷氨酸釋放的影響. 中國康復醫學雜志, 2019, 34(12): 1397-1402.
20. 艾明, 靳佳佳, 冉柳毅, 等. 神經膠質高親和力谷氨酸轉運體基因多態性與青少年非自殺性自傷的關聯研究. 中華行為醫學與腦科學雜志, 2018, 27(3): 222-225.
21. Darragh P D. The neuropathology of Self-Injurious Behavior: Studies using animal models. Brain Res, 2024, 1844(1): 149-172.
22. Sun A Y, Woods S, Findling R L, et al. Safety considerations in the psychopharmacology of pediatric bipolar disorder. Expert Opin Drug Saf, 2019, 18(9): 777-794.
23. Croarkin P E, MacMaster F P. Transcranial magnetic stimulation for adolescent depression. Child Adolesc Psychiatr Clin N Am, 2019, 28(1): 33-43.
24. 孫學禮. 精神病學第4版. 北京: 高等教育出版社, 2020: 197-207.
25. 孫亞男. 齊拉西酮聯合碳酸鋰治療青少年雙相I型障礙躁狂發作的療效評價. 中國現代藥物應用, 2021, 15(6): 209-211.
26. 陳燕. 齊拉西酮的研究進展. 國際精神病學雜志, 2015, 42(1): 138-140.
27. Keck P E Jr, Versiani M, Potkin S, et al. Ziprasidone in the trearment of acute bipolar mania: a three-week, placebocontrolled, double-blind, randomized trial. Am J Psychiatry, 2003, 160(4): 741-748.
28. Lakshmi N Y, Sidney H K, Sagar V P, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord, 2018, 20(2): 97-170.
29. 高駿波. 重復經顱磁刺激治療青少年抑郁癥非自殺性自傷研究進展. 中國健康心理學雜志, 2020, 28(11): 1738-1743.
30. 梁曉敏. 精神障礙住院患者自殺風險及其相關因素分析. 廣州: 廣州醫科大學, 2021.
31. 高赫, 童茂清, 樓忠澤, 等. 青少年雙相障礙門診患者非自殺性自傷行為的調查分析. 中國現代醫生, 2022, 60(15): 155-158.

Journal of Biomedical Engineering

Efficacy evaluation of repeated transcranial magnetic stimulation combined with bipolar depression triple therapy in reducing female adolescents’ non-suicidal self-injury

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