不同脑区高频重复经颅磁刺激对轻、中度阿尔茨海默病患者认知功能的影响  

Effects of high-frequency repetitive transcranial magnetic stimulation of different brain regions on cognitive function in patients with mild to moderate Alzheimer’s disease

作　　者：夏青春 那万秋[2] 薛凤玲 XIA Qing-chun;NA Wan-qiu;XUE Feng-ling(Huangshi Psychiatric Hospital,Huangshi 435109,China)

机构地区：[1]黄石市黄石精神病医院,435109 [2]湖州市第三人民医院

出　　处：《临床精神医学杂志》2023年第6期439-443,共5页Journal of Clinical Psychiatry

基　　金：浙江省医药卫生科技计划项目(2017KY645)。

摘　　要：目的:探讨不同脑区高频重复经颅磁刺激(rTMS)对轻、中度阿尔茨海默病(AD)患者认知功能的影响。方法:2018年1月至2020年12月湖州市第三人民医院150例AD患者随机分为前额叶组(49例),颞顶叶组(50例)和假刺激组(51例)。前额叶组和颞顶叶组给予真磁刺激治疗,而假刺激组给予假磁刺激治疗。分别于治疗前后,采用简易精神状态检查量表(MMSE),阿尔茨海默病评定量表-认知分量表(ADAS-cog)对三组患者的认知功能进行评定。结果:治疗后,前额叶组和颞顶叶组MMSE评分均明显高于治疗前(P均<0.05),ADAS-cog总分及各因子分均明显低于治疗前(P均<0.05),而假刺激组MMSE评分、ADAS-cog总分及各因子分均变化不明显(P均>0.05)。治疗后,颞顶叶组MMSE评分明显高于前额叶组和假刺激组(P均<0.01),ADAS-cog总分及各因子分均明显低于前额叶组和假刺激组(P均<0.01)。结论:左侧背外侧前额叶和左侧颞顶叶高频rTMS均可改善轻、中度AD患者的认知功能,但左侧颞顶叶高频rTMS对改善轻、中度AD患者的认知功能效果更好。Objective:To investigate the effects of high frequency repetitive transcranial magnetic stimulation(rTMS)in different cerebral cortex on cognitive function of dementia in patients with mild and moderate Alzheimer’s disease(AD).Method:150 AD patients in Huzhou Third Municipal Hospital from January 2018 to December 2020 were randomly diveded into prefrontal lobe group(n=49),temporal parietal lobe group(n=50)and false stimulation group(n=51).The prefrontal and temporal parietal lobe groups were treated with real magnetic stimulation,while the false stimulation group was treated with fake magnetic stimulation.The cognitive function of the three groups of patients were assessed by mini mental state examination(MMSE)and Alzheimer’s disease rating scale(ADAS-cog)before and 28 days after treatment.Results:After the treatment,the scores of MMSE were significantly increased and the scores of ADAS-cog and each factor were significantly decreased as compared to the baseline in the prefrontal lobe group and temporal parietal lobe group(all P<0.05)while there was no significantly difference compared with the baseline in the fake stimulation group(all P>0.05).The scores of MMSE in the temporal parietal lobe group were significantly higher than those of the prefrontal lobe group and the fake stimulation group(all P<0.01)and the scores of ADAS-cog and each factor in the temporal parietal lobe group were significantly lower than those of the prefrontal lobe group and the fake stimulation group(all P<0.01).Conclusion:High-frequency rTMS of left dorsolateral prefrontal lobe and left temporal parietal lobe can both improve cognitive function of patients with mild and moderate AD,but high-frequency rTMS of left temporal parietal lobe is more effective.

关 键 词：阿尔茨海默病 重复经颅磁刺激 认知功能 对照研究 

分 类 号：R749.3[医药卫生—神经病学与精神病学]