rTMS对aMCI患者认知功能的影响及对脑网络的调控作用  

Impacts of repetitive transcranial magnetic stimulation on the brain network regulation and cognitive function of patients with amnesiac mild cognitive impairment

作　　者：隆世宇 王晓明[2] 罗成[3] 刘新[2] 杨飞[2] 何苏[4] 何林[5] 张明[6] 

机构地区：[1]南充市第五人民医院与川北医学院附属医院神经科,四川南充637000 [2]川北医学院附属医院 [3]电子科技大学 [4]南充市第二人民医院 [5]南充市第五人民医院 [6]仪陇县人民医院

出　　处：《癫痫与神经电生理学杂志》2016年第1期6-11,F0002,共7页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的：观察重复经颅磁刺激（rTMS）对遗忘型轻度认知功能障碍（aMCI）患者认知功能的影响及对脑网络的调控作用。方法：将30例aMCI患者随机分为rTMS组（真刺激组）15例和rTMS假刺激组（假刺激组）15例。进行蒙特利尔认知评估量表（MoCA）、临床记忆量表（CMs）测试，采集结构性磁共振成像（sMRI），同时真刺激组采集其静息态功能磁共震成像（fMRI）数据；磁刺激参数：刺激部位为左侧额叶背外侧皮质（dIPFC），强度为RMT的90％，频率为15Hz，每日20个序列，间隔时间25S，5d为1个疗程，连续治疗2个疗程。rTMS治疗结束后再次进行量表测试，采集真刺激组fMRI数据。比较两组治疗前后的MoCA、CMS测试结果；分析以左侧dIPFC为感兴趣区域（ROI）的功能性连接情况。结果：①rTMS对aMCI的认知能力有改善作用；②真刺激组治疗后右侧额中、左侧三角部额下回、双侧丘脑等多个脑区与左侧dIPFC功能性连接增强，右侧补充运动区等脑区连接降低。结论：高频rT—MS对aMCI患者的默认模式网络（DMN）有修复作用。Objective：To observe the influence on patients with amnestic mild cognitive impairment （aMCl）patients and the regulating effect on brain network of repetitive transcranial magnetic stimulalon （rTMS）. Methods： 30 patients with aMCI, vere randomly divided into rTMS group, as the stimulation group（l 5 cases） and the control group（15 patients）. Both groups tested with Montreal cognitive assessment （MoCA）, Clinical Memory Scale （CMS） and sMRI. At the same time, the fMRI data of the stimulation group were collected. The stimulation site：dlPFC and 90% intension, RMT rate：15 Hz and 20 sequences per day （interval time was 25 seconds; one course of treatment lasted for 5 days and 2 courses were needed）. fter treatment the scale test data and fMRI data of the stimulation group were collected and MoCA and CMS test results were compared,Then the functional connect situation of dlPFC as ROI was analyzed. Results： rTMS had an ameliorative effect on the cognitive function of aMCI. After treat- ment, the encephalic region functional connect in the stimulation group was strenthened in the bilateral cerebellum of the epencephalon,the right superior temporal area and the right praecuneus area; bilateral angular gyrus and posterior cingulated cortex area were reduced. Conclusion： HF rTMS has a recovery effect on the DMN of patients with aMCI.

关 键 词：遗忘型轻度认知功能障碍(aMCI) 重复经颅磁刺激(rTMS) 静息态血氧水平依赖 功能磁共振成像(fMRI) 功能性网络连接 蒙特利尔认知评分量表(MoCA) 

分 类 号：R741.044[医药卫生—神经病学与精神病学] R742[医药卫生—临床医学]