高频rTMS对轻度认知障碍患者认知功能及神经活动的影响  

Effects of high-frequency rTMS on cognitive function and neural activity in mild cognitive impairment

作　　者：王涛[1] 郭志伟[1] 杜泳荟 蒋依 母其文[1] WANG Tao;GUO Zhiwei;DU Yonghui;JIANG Yi;MU Qiwen(Department of Medical Imaging & Institute of Brain Function Rehabilitation and Imaging,the Second Clinical School of Sichuan North Medical College/Nanchong Central Hospital,Nanchong,Sichuan,637000,China)

机构地区：[1]川北医学院第二临床医学院/南充市中心医院医学影像科&脑功能康复与成像研究所,四川南充637000

出　　处：《重庆医学》2021年第24期4176-4181,共6页Chongqing medicine

基　　金：四川省科技厅项目(SYZ202061);四川省南充市科技局市校合作项目(18SXHZ0434)。

摘　　要：目的探讨重复经颅磁刺激(rTMS)对轻度认知功能障碍(MCI)患者的认知功能及神经活动的影响。方法将纳入的40例MCI患者分为真刺激组和伪刺激组各20例。真刺激组给予、左侧背外侧前额叶连续10 d的rTMS(10 Hz)治疗;伪刺激组采用不产生真实有效刺激的伪刺激线圈,其余治疗参数均与真刺激组相同。分别于治疗前后进行神经心理学量表评测及静息态功能磁共振检查。结果(1)认知评分:治疗后真刺激组患者的简易精神状态量表(MMSE)、蒙特利尔认知评估量表-基础版(MoCA-B)、听觉词汇学习测验(瞬时记忆、N4、N5、N7)、波士顿命名测试(BNT)、动物词语流畅性测验(AFT)评分显著升高,连线测试A/B(TMT-A/B)评分显著降低;治疗后伪刺激组患者的瞬时记忆、N4评分升高(P<0.05)。(2)低频振幅(ALFF):治疗后真刺激组患者右侧岛叶、右侧岛盖部额下回的ALFF值显著升高,左侧枕中回、左侧角回、左侧舌回ALFF值显著降低(P<0.05)。治疗后伪刺激组患者右侧颞上回、右侧岛叶、左侧岛叶的ALFF值升高,右侧枕中回、右侧颞中回、左侧颞中回ALFF值显著降低(P<0.05)。(3)相关性分析:真刺激组患者左侧枕中回的ALFF改变值与TMT-B评分改变值(r=0.57,P<0.05)、左侧舌回的ALFF改变值与AVLT-N4评分改变值(r=-0.58,P<0.05)存在显著相关。结论高频rTMS可调节MCI认知相关脑区的神经活动,有效改善MCI患者认知功能损害。Objective To investigate the effects of repetitive transcranial magnetic stimulation(rTMS)on the cognitive function and neural activity in patients with mild cognitive impairment.Methods A total of 40 MCI patients were randomly divided into 20 cases in the true stimulation group and 20 cases in the pseudo-stimulation group.The true stimulation group was given with rTMS treatment at 10 Hz,left dorsolateral prefrontal for ten consecutive days;the pseudo-stimulation group was treated with a pseudo-stimulation coil that did not produce a real effective stimulus,and the rest of the treatment parameters were the same as in the real stimulation group.The neuropsychological scale and resting-state functional magnetic resonance examination were performed before and after treatment.Results(1)Cognitive scores:The Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment-Basic(MoCA-B),Auditory Verbal Learning Test(AVLT)(transient memory,N4,N5,N7),Boston Naming Test(BNT),AVLT scores were significantly higher and Trail making tests(TMT-A/B)scores were significantly lower for patients in the true stimulation group after treatment;the AVLT(transient memory,N4)scores were higher for patients in the pseudo-stimulation group after treatment(P<0.05).(2)Low frequency amplitude(ALFF):The ALFF values were significantly higher in the right insula and right subfrontal gyrus of the right insula cap in the true stimulation group,and significantly lower in the left middle occipital gyrus,left angular gyrus and left lingual gyrus after treatment(P<0.05).The ALFF values of the right superior temporal gyrus,right insula,and left insula were increased and the ALFF values of the right middle occipital gyrus,right middle temporal gyrus,and left middle temporal gyrus were significantly decreased in patients in the pseudo-stimulation group after treatment(P<0.05).(3)Correlation analysis:The change values of the ALFF in the left middle occipital gyrus and TMT-B and left lingual gyrus of patients in the true stimulation group before and after

关 键 词：重复经颅磁刺激 轻度认知功能障碍 静息态功能磁共振 低频振幅 

分 类 号：R749.1[医药卫生—神经病学与精神病学]