摘要
目的观察重复经颅磁刺激(rTMS)的间歇性θ节律刺激(iTBS)对卒中后认知功能障碍(PSCI)患者的临床疗效。方法选取2020年7月1日至2021年6月30日上海市第二康复医院首次发病的60例PSCI患者为研究对象,按照随机数字表法分为iTBS组(31例)和假刺激组(29例)。两组在基础治疗和认知功能训练的基础上分组训练。iTBS组额外增加iTBS治疗,假刺激组额外增加假刺激治疗。共治疗4周,分别于治疗前后采用认知评估量表和日常生活活动能力评定表进行疗效评估,在治疗前后检测同型半胱氨酸(Hcy)、C反应蛋白(CRP)、乳酸脱氢酶(LDH)水平。结果治疗前,两组简易精神状态评价量表(MMSE)、蒙特利尔认知评估量表(MoCA)、额叶功能评价量表(FAB)、日常生活能力表(BI)、正序记忆、倒序记忆、延迟回忆、注意力评分和Hcy、CRP、LDH水平比较,差异无统计学意义(P>0.05)。治疗后,两组上述评分高于治疗前,Hcy、CRP、LDH水平低于治疗前,且iTBS组正序记忆、倒序记忆、注意力评分高于假刺激组,LDH水平低于假刺激组,差异有统计学意义(P<0.05)。结论iTBS更有助于改善PSCI,这与改善炎性反应有关。
Objective To observe the clinical efficacy of repetitive transcranial magnetic stimulation(rTMS)intermittent θ burst stimulation(iTBS)in patients with post-stroke cognitive impairment(PSCI).Methods A total of 60 PSCI patients with the first onset in Shanghai Second Rehabilitation Hospital from July 1,2020 to June 30 were selected as the research objects.According to the random number table method,they were divided into the iTBS group(31 cases)and the sham stimulation group(29 cases).The two groups were trained on the basis of basic treatment and cognitive function training.The iTBS group received additional iTBS treatment and the sham stimulation group received additional sham stimulation treatment.A total of 4 weeks of treatment were performed,and the efficacy was evaluated by Montreal cognitive assessment(MoCA)and Batthel Index at the begin and end of treatment.The levels of homocysteine(Hcy),C-reactive protein(CRP)and lactate dehydrogenase(LDH)were detected at the begin and end of treatment.Results Before treatment,there were no significant differences in mini-mental status examination(MMSE),MoCA,frontal assessment battery(FAB),Batthel Index(BI),positive order memory,reverse order memory,delayed recall,attention score,and Hcy,CRP and LDH levels between the two groups(P>0.05).After treatment,the above scores of the two groups were higher than those before treatment,the levels of Hcy,CRP and LDH were lower than those before treatment,and positive order memory,reverse order memory,attention score of the iTBS group were higher than those of the sham stimulation group,and the LDH level of the iTBS group was lower than that of the sham stimulation group,and the differences were statistically significant(P<0.05).Conclusion iTBS is more helpful in improving the PSCI,which is associated with improved inflammatory response.
作者
裴松
王健
夏家怡
PEI Song;WANG Jian;XIA Jiayi(Department of Rehabilitation,Renhe Hospital of Baoshan District,Shanghai 200431,China;School of Rehabilitation Science,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Department of Rehabilitation,Shanghai Second Rehabilitation Hospital,Shanghai 200431,China)
出处
《重庆医学》
CAS
2022年第18期3120-3125,共6页
Chongqing medicine
基金
2020年上海市卫生健康委员会科研课题(20204Y0369、20204Y0373)。
关键词
重复经颅磁刺激
间歇性θ节律刺激
卒中
认知障碍
疗效
repetitive transcranial magnetic stimulation
intermittent θ burst stimulation
stroke
cognitive impairment
efficacy
