低频与高频重复经颅磁刺激联合多巴丝肼对帕金森病患者轻度认知功能障碍的影响  

Effects of low-frequency and high-frequency repetitive transcranial magnetic stimulation combined with levodopa and benserazide hydrochloride on mild cognitive impairment in patients with Parkinson disease

作　　者：赵启媛 丛光燕 吕鸿燕 张勇 李苇 胡盼盼[2] 汪凯[2] Zhao Qiyuan;Cong Guangyan;Lyu Hongyan;Zhang Yong;Li Wei;Hu Panpan;Wang Kai(Neurology Department,Lu'an Hospital of Anhui Medical University,Lu'an 237000,China;Neurology Department,The First Affiliated Hospital of Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学附属六安医院神经内科,六安237000 [2]安徽医科大学第一附属医院神经内科,合肥230032

出　　处：《中华行为医学与脑科学杂志》2024年第3期199-205,共7页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金(82171917)。

摘　　要：目的探讨低频及高频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合多巴丝肼对帕金森病(Parkinson disease,PD)患者的认知功能的影响。方法选取2020年1月—2022年6月就诊的存在轻度认知功能障碍的PD患者90例,按入院顺序分为单纯药物组(n=30)、低频+药物组(n=30)及高频+药物组(n=30)。单纯药物组患者采用口服多巴丝肼治疗,低频+药物组、高频+药物组患者在口服多巴丝肼的基础上分别联合低频、高频rTMS治疗。应用数字广度测验(digital span,DS)、中文听觉词汇学习测验(Chinese auditory learning test,CALT)、线段方向判定测验(judgment of line orientation test,JLOT)及词汇流畅性测验(verbal fluency test,VFT)分别在治疗前及治疗4周后对所有被试进行认知功能评估。应用SPSS 26.0进行统计分析。组内治疗前后比较采用配对t检验,组间比较采用单因素方差分析。结果单纯用药组患者治疗前和治疗4周后比较MoCA、DS顺背、DS倒背、CALT即刻回忆、CALT延迟回忆、JLOT、VFT评分均差异无统计学意义(t=-1.157,-0.648,-0.215,-0.290,-0.154,-0.782,-0.960,均P>0.05)。低频+药物组及高频+药物组治疗4周后MoCA、DS顺背、DS倒背、CALT即刻回忆、CALT延迟回忆、JLOT、VFT评分均较治疗前升高(低频+药物组:t=-16.357,-11.379,-7.999,-11.805,-16.624,-15.996,-17.241,均P<0.05;高频+药物组:t=-25.198,-13.971,-13.904,-25.831,-26.382,-20.108,-15.643,均P<0.05)。三组治疗前MoCA、DS顺背、DS倒背、CALT即刻回忆、CALT延迟回忆、JLOT、VFT评分,均差异无统计学意义(均P>0.05),三组治疗后MoCA、DS顺背、DS倒背、CALT即刻回忆、CALT延迟回忆、JLOT、VFT评分[单纯药物组:(20.37±1.96)分,(4.37±1.19)分,(2.80±0.55)分,(6.93±1.70)分,(5.17±1.09)分,(15.50±2.69)分,(10.73±1.55)分;低频+药物组:(23.83±2.32)分,(5.87±0.94)分,(3.87±0.73)分,(9.17±1.74)分,(8.13±1.50)分,(20.77±2.19)分,(13.30±1.73)分;高频+药物组:(27.17�ObjectiveTo investigate the effects of low-frequency and high frequency repetitive transcranial magnetic stimulation(rTMS)combined with levodopa and benserazide hydrochloride on mild cognitive impairment in patients with Parkinson disease(PD).MethodsTotally 90 PD patients with mild cognitive impairment who visited from January 2020 to June 2022 were included,and they were divided into a simple drug group(n=30),drug+low-frequency group(n=30),and drug+high-frequency group(n=30)according to the order of admission.The patients in the simple drug group were treated with oral levodopa and benserazide hydrochloride,while the patients in drug+low-frequency and drug+high-frequency groups were treated with low-frequency or high-frequency rTMS on the basis of oral levodopa and benserazide hydrochloride.Montreal cognitive assessment(MoCA),digital span(DS),Chinese auditory learning test(CALT),the judgment of line orientation test(JLOT)and verbal fluency test(VFT)were used to evaluate the cognitive function of patients before and after 4 weeks of treatment.SPSS 26.0 was used for statistical analysis.The paired t-test was used for intra-group comparison before and after treatment,while one-way ANOVA was used for inter-group comparison.ResultsThere were no significant differences in MoCA,DS anterograde,DS backward,CALT immediate recall,CALT delayed recall,JLOT,and VFT scores among patients in the simple drug group before and after 4 weeks of treatment(t=-1.157,-0.648,-0.215,-0.290,-0.154,-0.782,-0.960,all P>0.05).After 4 weeks of treatment,MoCA,DS anterograde,DS backward,CALT immediate recall,CALT delayed recall,JLOT and VFT scores in drug+low-frequency group and drug+high-frequency group were higher than before treatment(drug+low frequency group:t=-16.357,-11.379,-7.999,-11.805,-16.624,-15.996,-17.241,all P<0.05;drug+high-frequency group:t=-25.198,-13.971,-13.904,-25.831,-26.382,-20.108,-15.643,all P<0.05).There were no statistically significant differences in the scores of MoCA,DS anterograde,DS backward,CALT immediate recall,

关 键 词：重复经颅磁刺激 多巴丝肼 帕金森病 认知功能 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]