高频重复经颅磁刺激治疗脑卒中后非空间注意障碍的效果  

Effect of High-Frequency Repetitive Transcranial Magnetic Stimulation in the Treatment of Non-spatial Attention Disorder After Stroke

作　　者：王国胜[1] 方明珠 梁英姿 关晨霞[1] 郭君[1] 李哲[1] WANG Guosheng;FANG Mingzhu;LIANG Yingzi;GUAN Chenxia;GUO Jun;LI Zhe(Department of Rehabilitation Medicine,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第五附属医院康复医学科,河南郑州450052

出　　处：《河南医学研究》2025年第2期216-220,共5页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190431)。

摘　　要：目的探讨左侧背外侧前额叶(DLPFC)高频重复经颅磁刺激(rTMS)对脑卒中后非空间注意障碍患者的注意功能和事件相关电位P300的影响。方法采用随机对照试验设计,将43例脑卒中后非空间注意障碍患者随机分为观察组和对照组。两组患者均接受常规康复及药物治疗,观察组在此基础上接受高频rTMS治疗。所有患者在进行治疗前和治疗4周后进行蒙特利尔认知评估量表(MoCA)、数字广度测试(DST)、字母删除测验进行注意功能的评定,并评估两组患者事件相关电位P300潜伏期和波幅的改善情况。结果治疗4周后,观察组和对照组MoCA、DST、字母删除测验评分均较治疗前提高,且观察组高于对照组(P<0.05)。观察组和对照组P300潜伏期均较治疗前缩短,且观察组缩短幅度更大(P<0.05);观察组和对照组P300波幅均较治疗前增高,且观察组增高幅度更大(P<0.05)。结论高频rTMS治疗能显著改善脑卒中后患者的非空间注意障碍,P300可作为评估注意功能和rTMS治疗效果的指标。Objective To explore the effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)in the left dorsolateral prefrontal lobe(DLPFC)on attentional function and event-related potential P300 in patients with non-spatial attention disorders after stroke.Methods A randomized controlled experimental design was used to randomly assign 43 patients with post-stroke non-spatial attention disorder into observation group and control group.Patients in both groups received conventional rehabilitation and drug therapy,and the observation group received high-frequency rTMS therapy on the basis of conventional rehabilitation and drug therapy.Attention function was assessed by Montreal cognitive assessment(MoCA),digital span test(DST)and letter deletion test before treatment and 4 weeks after treatment.The improvement of the latency and amplitude of event-related potential P300 in the two groups was evaluated.Results After 4 weeks of treatment,the scores of MoCA,DST and letter deletion test in observation group and control group were higher than before treatment,and observation group was higher than control group(P<0.05).The incubation period of P300 in both the observation group and the control group was shorter than before treatment,and the shortening range was greater in the observation group(P<0.05).The amplitude of P300 in both the observation group and the control group was higher than before treatment,and the increase amplitude in the observation group was greater(P<0.05).Conclusion High-frequency rTMS treatment can significantly improve the non-spatial attention disorder in patients with stroke,and P300 can be used as an indicator to evaluate the attention function and the effect of rTMS treatment.

关 键 词：脑卒中 重复经颅磁刺激 非空间注意障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]