The Journal of Shahid Sadoughi University of Medical Sciences
مجله علمي پژوهشي دانشگاه علوم پزشكي شهید صدوقی يزد
JSSU
Medical Sciences
http://jssu.ssu.ac.ir
20
journal20
2228-5741
2228-5733
fa
jalali
1403
12
1
gregorian
2025
3
1
32
12
online
1
fulltext
fa
اثربخشی تحریک الکتریکی مستقیم فراجمجمه ای(tDCS) بر شدت درد ، اضطراب و افسردگی در بیماران مبتلا به آرتریت روماتوئید
Effectiveness of Transcranial Direct Current Stimulation (Tdcs) on Pain Intensity, Anxiety and Depression in Patients with Rheumatoid Arthritis
روانشناسی
Psychology
پژوهشي
Original article
<div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:18.0pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">مقدمه:</span></span></b> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">بیماران آرتریت روماتوئید (</span></span><span dir="LTR" new="" roman="" style="font-family:" times="">RA</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">) اغلب درد مزمنی را نشان می</span></span><span dir="LTR" new="" roman="" style="font-family:" times=""></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">دهند که ممکن است علی رغم درمان علائم عینی التهاب باقی بماند و باعث آسیب های جسمی و روانی قابل توجهی شود. هدف پژوهش حاضر بررسی اثربخشی تحریک الکتریکی مستقیم فراجمجمهای (</span></span><span dir="LTR" new="" roman="" style="font-family:" times="">tDCS</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">)</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">برکاهش</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">شدت درد، اضطراب و افسردگی در بیماران مبتلا به آرتریت روماتوئید بود.</span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:18.0pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">روش بررسی:</span></span></b> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">پژوهش حاضر نیمه آزمایشی با پیشآزمون </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">_</span><span style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> پسآزمون و پیگیری یک ماهه</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">با گروه کنترل بود</span></span><span dir="LTR" new="" roman="" style="font-family:" times="">.</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> جامعه آماری شامل کلیه زنان و مردان مبتلا به آرتریت روماتوئید مراجعه کننده به بخش روماتولوژی بیمارستانهای شریعتی و خانواده تهران در سال 1403 بودند که به صورت نمونه گیری در دسترس30 نفر انتخاب شده و به صورت تصادفی در گروههای آزمایش و کنترل قرار گرفتند. از</span></span><span dir="LTR" new="" roman="" style="font-family:" times="">tDCS</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> آنودال جهت</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">تحریک </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">DLPFC</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">چپ و کاتودال بازداری</span></span><span dir="LTR" new="" roman="" style="font-family:" times="">DLPFC </span><span style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> راست استفاده شد. شرکتکنندگان پیش _</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">پس و در دوره پیگیری یک ماهه توسط شاخص درد مزمن </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">McGill</span><span style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> ،</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">مقیاس افسردگی و اضطراب </span></span><span dir="LTR" new="" roman="" style="font-family:" times=""> Beck</span> <span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">ارزیابی شدند. تجزیه و تحلیل داده ها با استفاده از تحلیل واریانس با اندازه گیری مکرر و بهره گیری از </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">SPSS-16</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> انجام شد.</span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:18.0pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">نتایج:</span></span></b> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">یافتهها نشان داد که </span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">tDCS</span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> بر کاهش شدت درد و اضطراب در پسآزمون و در پیگیری یک ماهه در سطح (</span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">p<0/05</span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">) معنی</span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""></span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">دار بوده، در متغیر افسردگی نتایج در پسآزمون معنادار بوده (</span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">p<0/05</span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">) اما در پیگیری یک ماهه معنیدار (</span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">p>0/05</span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">) نبوده است. در گروه گواه نمرات در هر سه مرحله تفاوت چندانی نداشت.</span></span> <span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:18.0pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">نتیجهگیری:</span></span></b> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">نتایج نشان میدهد </span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">tDCS</span></span><span style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> تاثیر بیشتری در کاهش درد، اضطراب و علائم افسردگی در مقایسه با دارونما داشته و قادر به کاهش التهاب و بهبود کیفیت زندگی داوطلبان از طریق مراقبتهای پزشکی سریع و پیروی بیشتر از دستورات درمانی برای کاهش فعالیت بیماری یا حتی رسیدن به بهبودی کامل است.</span></span></span></span></span></span></span><br>
</div>
<div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:18.0pt"><span calibri="" style="font-family:"><b><span new="" roman="" style="font-family:" times="">Introduction:</span></b> <span lang="EN" new="" roman="" style="font-family:" times="">Rheumatoid arthritis is a chronic autoimmune disease characterized by joint synovitis and damage to the surrounding cartilage and soft tissues. In this study, it was assumed that stimulation of the prefrontal cortex (DLPFC) by transcranial direct current </span><span new="" roman="" style="font-family:" times="">stimulation </span><span lang="EN" new="" roman="" style="font-family:" times="">(</span><span new="" roman="" style="font-family:" times="">tDCS</span><span lang="EN" new="" roman="" style="font-family:" times="">) has reduced pain intensity in the rheumatoid arthritis patients and improved anxiety and depression outcomes</span><span dir="RTL" lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">.</span></span><b><span style="font-family:"Times New Roman",serif"></span></b></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:18.0pt"><span calibri="" style="font-family:"><b><span new="" roman="" style="font-family:" times="">Methods:</span></b><span new="" roman="" style="font-family:" times=""> The current research was a semi-experimental design that involved a pre-test, post-test and a one-month follow-up with a control group The statistical population included all men and women diagnosed with rheumatoid arthritis who referred to the Rheumatology Department of Tehran's Family and Shariati Hospitals in 2024. A total of thirty individuals were selected through available sampling and then randomly assigned to either the experimental and control groups. Anodal tDCS was applied to stimulate the left dorsolateral prefrontal cortex (DLPFC), while cathodal tDCS was employed to inhibit the right DLPFC. Participants were assessed before-after and in the one-month follow-up period using the McGill Chronic Pain Index, and the Beck Depression and Anxiety Scale. Data analysis was conducted utilizing repeated measures analysis of variance and was performed with SPSS-16.</span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:18.0pt"><span calibri="" style="font-family:"><b><span new="" roman="" style="font-family:" times="">Results:</span></b><b> </b><span new="" roman="" style="font-family:" times="">The findings showed that </span><span new="" roman="" style="font-family:" times="">transcranial direct current stimulation (</span><span new="" roman="" style="font-family:" times="">tDCS) significantly reduced pain and anxiety levels in both the post-test and one-month follow-up, with P-values less than 0.05. Regarding depression, the post-test results were also significant (p<0.05), but </span><span new="" roman="" style="font-family:" times="">in the one-month follow-up, this effect was no longer significant (p>0.05). In contrast, the control group exhibited little variation across all three phases. </span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:18.0pt"><span calibri="" style="font-family:"><b><span new="" roman="" style="font-family:" times="">Conclusion:</span></b><b> </b><span new="" roman="" style="font-family:" times="">The results show that tDCS has a greater effect in reducing pain, anxiety and depression symptoms compared to placebo and is able to reduce inflammation and improve the quality of life of volunteers through prompt medical care and more compliance with treatment orders to reduce disease activity or even reach the recovery is complete</span><span new="" roman="" style="font-family:" times="">.</span></span></span></span><br>
</div>
تحریک جریان مستقیم فراجمجمه ای(tDCS), شدت درد, اضطراب و افسردگی, آرتریت روماتوئید.
Transcranial direct current stimulation (tDCS), Intensity of pain, Anxiety and depression, Rheumatoid arthritis.
8534
8548
http://jssu.ssu.ac.ir/browse.php?a_code=A-10-5426-1&slc_lang=fa&sid=1
Maryam
Sadeqpur
مریم
صادقپور
sadeqpur.ma@fh.lu.ac.ir