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外2018 (IF2.072 Brain and Behavior)连续低频rTMS刺激双侧DLPFC对原发性失眠患者血清中BDNF和GABA的影响 XianjuZhou
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Brain and Behavior. 2019;e01206. | 1 of 8 https://doi.org/10.1002/brb3.1206 wileyonlinelibrary.com/journal/brb3 Received: 2 September 2018 | Revised: 6 December 2018 | Accepted: 9 December 2018 DOI: 10.1002/brb3.1206 O R I G I N A L R E S E A R C H The Effect of sequential bilateral low‐frequency rTMS over dorsolateral prefrontal cortex on serum level of BDNF and GABA in patients with primary insomnia Jie Feng1* | Qing Zhang2* | Chengliang Zhang2 | Zhongmin Wen1 | Xianju Zhou2,3 This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. 2019 The Authors. Brain and Behavior published by Wiley Periodicals, Inc. *The two authors equally contributed to this work. 1Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China 2Laboratory of Neurological, Department of Neurology, Changzhou No.2 People’s Hospital, The Affiliated Hospital of Nanjing Medical University, Changzhou, China 3Department of Neurology, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China Correspondence Xianju Zhou, Laboratory of Neurological, Department of Neurology, Changzhou No.2 People’s Hospital, The Affiliated Hospital of Nanjing Medical University, Changzhou, China. Email: xianju_zhou@yahoo.com Funding information National Natural Science Foundation of China, Grant/Award Number: NO. 81471338 and NO.81671284; Changzhou Sci& Tech Program Grant, Grant/Award Number: CE20145045 and CE2015; Changzhou High‐Level Medical Talents Training Project, Grant/Award Number: NO.2016CZLJ018 Abstract Objective: This study aimed to investigate the effect of sequential bilateral low‐fre‐ quency repetitive transcranial magnetic stimulation (rTMS) over dorsolateral prefron‐ tal cortex (DLPFC) on patients with primary insomnia (PI). Methods: A total of 32 eligible right‐handed participants diagnosed by PI according to International classification of sleep disorders (ICD‐3) were recruited into this study. Participants received 10 daily sessions of sequential bilateral 1 Hz rTMS over DLPFC. Before and after the whole procedure of rTMS, patients were assessed by Pittsburgh Sleep Quality Index (PSQI) for the severity of sleep disturbance. Meanwhile, serum concentration of brain‐derived neurotrophic factor (BDNF) and gamma‐aminobutyric acid (GABA) in patients was measured by ELISA and UPLC, re‐ spectively. Moreover, the amplitude of MEPs reflecting the right cortical excitability was examined. Finally, Pearson correlation analysis was performed to evaluate the correlation among the change of these variables. Results: After rTMS treatment, the PSQI score was markedly decreased as compared to pre‐rTMS; the concentrations of serum BDNF and GABA were significantly higher; the amplitude of MEPs was markedly reduced. Pearson correlation analysis revealed that the change of PSQI score was negatively associated with the alteration of serum BDNF level and serum GABA level, and positively associated with the change of MEPs amplitude; the change of MEPs amplitude was negatively associated with fold change in the serum BDNF level and the serum GABA level; the increase in serum GABA level was positively associated with the serum BDNF level. Conclusions: A sequential bilateral low‐frequency rTMS over DLPFC significantly im‐ proves primary insomnia probably by increasing the level of BDNF and GABA in the brain and reducing cortical excitability. K E Y W O R D S brain‐derived neurotrophic factor, primary insomnia, repetitive transcranial magnetic stimulation, γ‐aminobutyric acid

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