计算机辅助认知训练对非痴呆型血管性认知障碍患者认知功能及P300的影响  

Effect of computer-assisted cognitive training on cognitive function and P300 in patients with vascular cogni- tive impairment no dementia

作　　者：林延敏[1] 高呈飞 许金霞[3] 苏文华[4] 汤乃苏[1] 朱其秀[4] 

机构地区：[1]青岛大学医学院,青岛266000 [2]威海市立医院康复科 [3]潍坊医学院康复基础教研室 [4]青岛大学附属医院康复医学科

出　　处：《中华物理医学与康复杂志》2015年第5期340-343,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的探讨计算机辅助认知训练对非痴呆型血管性认知障碍（VCIND）患者认知功能及事件相关电位（ERP）P300的影响。方法选取VCIND患者60例，按照随机数字表法将其分为训练组和对照组，每组30例。2组患者均给予常规药物治疗和传统康复训练，训练组在此基础上增加计算机辅助认知训练，40min／次，每日1次，每周6次，共4周。治疗前及治疗4周后，采用简易智能精神量表（MMSE）、蒙特利尔认知评估量表（MoCA）、Barthel指数（BI）、肌电诱发电位仪对2组患者的认知功能、日常生活活动（ADL）能力、P300进行评定。结果治疗前，2组患者MoCA、MMSE、BI评分比较，差异无统计学意义（P〉0．05）。2组患者治疗后MoCA总分、视空间与执行功能、注意力、语言、延迟记忆、MMSE及BI评分均较治疗前有所改善（P〈0．05）。治疗后，训练组MoCA总分[（22．40±4．38）分]、视空间与执行功能[（3．27±0．58）分]、注意力[（4．30±1．60）分]、语言[（2．67±0．48）分]、延迟记忆[（3．67±0．80）分]、MMSE[（22．03±3．55）分]、BI评分[（82．17±11．28）分]较对照组改善明显（P〈0．05）。治疗前，2组患者P300潜伏期、波幅之间比较，差异无统计学意义（P〉0．05）。2组患者治疗后P300潜伏期较治疗前显著缩短（P〈0．05），波幅显著增高（P〈0．05）。治疗后，训练组P300潜伏期[（352．10±30．68）ms]较对照组P300潜伏期[（356．45±40．30）ms]短，波幅[（8．65±1．18）μV]较对照组波幅[（6．73±1．81）μV]高，差异有统计学意义（P〈0．05）。结论计算机辅助认知训练能有效改善VCIND患者的认知功能，提高其ADL能力。Objective To explore the effect of computer-aided cognitive training on cognitive function and auditory event-related potential P300 in patients with vascular cognitive impairment no dementia （VCIND）. Methods Sixty VCIND patients were randomly divided into two groups namely a training group and a control group, each of 30. Both groups were given routine drug treatment and the traditional rehabilitation training. At the same time, the training group was additionally given 40min computer-aided cognitive training once a day, six times a week, lasing 4 weeks. Before and after four weeks of treatment, the cognitive function, the ability of daily life （ADL） and P300 of the two groups were assessed using mini-mental state examination（MMSE） , the Montreal cog- nitive assessment （MoCA） , Barthel Index （BI） and Motor evoked potential instrument respectively. Results Before treatment, no significant difference was found in the average MoCA, MMSE and BI scores of the two groups. After treatment, improvement was observed in the total MoCA scores （22. 40 ± 4. 38）, as well as the average score, of visual space and executive function （ 3.27 ± 0.58 ） , attention （4.30 ± 1.60 ） , language （2.67 ± 0.48 ） , delayed memory （3.67±0.80）, MMSE （22.03 ±3.55） and BI （82. 17 ± 11.28） in the training group com- pared with the control group. Before treatment, there was no significant difference in the P300 latency and ampli- tude between the two groups. After treatment, however, the P300 latency of the training group decreased to （352.1 ± 30.68） ms, significantly lower than the control group [ （356.45 ± 40.30） msl and that before treat- ment. Meanwhile, the amplitude rose to（ 8.65 ± 1.18） μV, significantly higher than the control group [ （ 8.65 ± 1.18） μV] and that before treatment. Conclusion Computer-aided cognitive training can effectively improve thecognitive function of patients with VCIND and promote their ADL.

关 键 词：计算机辅助训练 非痴呆型血管性认知障碍 MOCA 事件相关电位P300 

分 类 号：R749.1[医药卫生—神经病学与精神病学]