经颅直流电刺激在不同类型老年脑卒中后认知障碍患者康复中的应用及相应参数的筛选  

Application of Transcranial Direct Current Stimulation in Rehabilitation of Elderly Patients with Cognitive Impairment after Stroke of Different Types and Screening of Corresponding Parameters

作　　者：王莎[1] 郝利霞[1] 梁宇[1] 张琰[1] Wang Sha;Hao Lixia;Liang Yu;Zhang Yan(Department of Rehabilitation,The Affiliated Hospital of Inner Mongolia Medical University,Inner Mongolia 010050)

机构地区：[1]内蒙古医科大学附属医院康复科,呼和浩特010050

出　　处：《国际老年医学杂志》2023年第6期665-668,共4页International Journal of Geriatrics

基　　金：内蒙古自然科学基金(2019LH08021);内蒙古医科大学科技百万工程联合项目[YKD2018KJBW(LH)007]

摘　　要：目的研究经颅直流电刺激(tDCS)在不同类型老年脑卒中后认知障碍(PSCI)患者康复中的应用及相应参数的筛选。方法选取内蒙古医科大学附属医院2019年6月~2021年12月收治的110例脑卒中后认知障碍患者作为研究对象,其中非遗忘型56例,遗忘型54例。非遗忘型患者随机分为A组(31例)以及B组(25例),遗忘型患者随机分为C组(24例)以及D组(30例),均采取ZN8020型智能电刺激器进行治疗。A、C组刺激电流设为2.0 mA,B、D组刺激电流设为1.0 mA。比较两组的治疗效果[简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)]、记忆力[听觉词语学习测验(AVLT)]及执行力[形状连线测验(STT)]之间的差异。结果治疗前,A、B组MoCA、MMSE、AVLT及STT比较,差异均无统计学意义(P>0.05);治疗后,A、B组各评分均高于治疗前(P<0.05),且B组均高于A组(P<0.05)。治疗前,C、D组MoCA、MMSE、AVLT、STT比较,差异均无统计学意义(P>0.05);治疗后,C、D组各评分均高于治疗前,且C组均高于D组(P<0.05)。结论在老年PSCI患者tDCS康复治疗中,建议非遗忘型患者电流选择1.0 mA,遗忘型患者电流选择2.0 mA。Objective To investigate the application of transcranial direct current stimulation(tDCS)in the rehabilitation of different types of elderly patients with cognitive impairment after stroke(PSCI)and the screening of corresponding parameters.Methods A total of 110 patients with cognitive impairment after stroke admitted to the Affiliated Hospital of Inner Mongolia Medical University from June 2019 to December 2021 were selected as the study subjects,including 56 cases of non-amnestic type and 54 cases of amnestic type.Non-amnestic patients were randomly divided into group A(n=31)and group B(n=25).Amnestic patients were randomly divided into group C(n=24)and group D(n=30).Stimulation currents were set to 2.0 mA for groups A and C and 1.0 mA for groups B and D.The treatment effects[Mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA)],memory[Auditory word learning test(AVLT)]and executive ability[Shape trail making test(STT)]were compared between the two groups.Results Before treatment,there was no significant difference in MoCA,MMSE,AVLT and STT between group A and group B(P0.05).After treatment,the scores of group A and group B were higher than those before treatment(P0.05),and group B was higher than group A(P0.05).Before treatment,there was no significant difference in MoCA,MMSE,AVLT and STT between groups C and D(P0.05);after treatment,the scores of groups C and D were higher than those before treatment,and group C was higher than group D(P0.05).Conclusion In tDCS rehabilitation for elderly patients with PSCI,1.0 mA is recommended for non-amnestic patients and 2.0 mA for amnestic patients.

关 键 词：经颅直流电刺激 脑卒中后认知障碍 康复 认知功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学] R493