Objective  To investigate the effects of combined electroencephalography (EEG) biofeedback and escitalopram treatment on cognitive function and blood inflammatory factor and neurotrophic factor levels in patients with schizophrenia compared to escitalopram treatment alone.

Methods  The clinical data of schizophrenia patients who received treatment in The Affiliated Kangning Hospital of Wenzhou Medical University from January 2020 to March 2022 were retrospectively analysed, and the patients were divided into the escitalopram group (treated with oral Escitalopram), the EEG biofeedback group (treated with EEG biofeedback therapy) and the combination therapy group (treated with EEG biofeedback therapy combined with Escitalopram) according to the different treatment regimens. One-way ANOVA analysis was used to compare the overall clinical treatment effectiveness and cognitive function [Mini-mental State Examination (MMSE) and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA)] of three groups of patients, and the differences in serum inflammatory factor indicators [tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and interleukin-2 (IL-2)] and neurotrophic factor indicators [nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF) nad glial cell derived neurotrophic factor (GDNF)] before and after treatment. The occurrence of adverse reactions were observed.

Results  Clinical data of a total of 109 patients with schizophrenia were collected, including 36 in the escitalopram group, 36 in the EEG biofeedback group, and 37 in the combination therapy group. Compared with the escitalopram group and the EEG biofeedback group, the combination therapy group had a higher overall effective rate (P<0.05). After treatment, the scores of MMSE and LOTCA, and the levels of NGF, BDNF and GDNF significantly increased in all three groups of patients, while the levels of TNF-α, CRP and IL-2 significantly decreased (P<0.05); compared with the escitalopram group and the EEG biofeedback group, the combination therapy group had higher scores of MMSE and LOTCA, higher levels of NGF, BDNF and GDN, and lower levels of TNF-α, CRP and IL-2 (P<0.05). There was no statistically significant difference in the incidence of adverse reactions and total incidence of adverse reactions among the three groups of patients (P>0.05).

Conclusion  The combination therapy of EEG biofeedback and escitalopram has a more significant therapeutic effect than monotherapy, and can enhance the cognitive function, improve the neurological function, and inhibit the inflammatory response in patients with schizophrenia.

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