ABSTRACT
Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) and fluoxetine on depression and cognition in the treatment of post-stroke depression (PSD).Methods A total of 82 PSD patients were divided into a treatment group and a control group using a random number table.Besides conventional neurological therapy,the treatment group was treated with rTMS combined with fluoxetine,while the control group was treated only with fluoxetine.Forty healthy persons acted as normal controls.The Hamilton depression rating scale (HAMD) was used to evaluate depressed emotions,and event-related potential (ERP) P300 and exploratory eye movement (EEM) were used to evaluate cognitive function.The three groups were tested before treatment and after 8 weeks of treatment.Results After 8 weeks of treatment the HAMD scores in both the treatment and control groups had decreased significantly compared with before treatment.The HAMD scores decreased significantly more in the treatment group than in the control group.Before treatment,the N2 and P3 iatencies of P300 in the treatment and control groups were significant longer than those in the normal group,and the average amplitude of P3 in the treatment and control groups was significantly lower than among the normal controls.Before treatment,the number of eye fixations (NEF) and the average responsive search score (RSS) in the treatment group and control groups were significantly lower than in the normal group.After 8 weeks after treatment,the N2 and P3 latencies were significantly shorter and the amplitude of P3 was significantly higher in the treatment and control groups than before treatment.The NEF and the average RSS in the treatment and control groups had increased significantly compared with before treatment.All of these indexes improved significantly more in the treatment group than in the control group.Conclusion rTMS combined with fluoxetine can improve depression and cognitive function among PSD patients better than antidepressant treatment alone.