经颅直流电刺激对轻度认知功能障碍患者工作记忆的临床效果  

Clinical effects of transcranial direct current stimulation on working memory in patients with mild cognitive impairment

作　　者：李昭辉 邱凌鹤 过苑 顾君[2] LI Zhaohui;QIU Linghe;GUO Yuan;GU Jun(Department of Internal Medicine,Wuxi Central Rehabilitation Hospital,Jiangsu Province,Wuxi214151,China;Department of General Psychiatry,Wuxi Mental Health Center,Jiangsu Province,Wuxi214151,China;Psychometric Laboratory,Wuxi Mental Health Center,Jiangsu Province,Wuxi214151,China)

机构地区：[1]江苏省无锡市中心康复医院内科,江苏无锡214151 [2]江苏省无锡市精神卫生中心精神科,江苏无锡214151 [3]江苏省无锡市精神卫生中心心理测定室,江苏无锡214151

出　　处：《中国当代医药》2025年第5期61-65,70,共6页China Modern Medicine

基　　金：江苏省无锡市卫生计生委青年项目(Q201816);江苏省无锡市医学发展学科项目(FZXK2021012)。

摘　　要：目的探讨经颅直流电刺激(tDCS)对轻度认知障碍(MCI)患者工作记忆的效果。方法选取2021年1月至2022年12月无锡市精神卫生中心收治的70例MCI患者作为研究对象,采用随机数字表法将其分为假刺激组(n=35)和tDCS组(n=35)。tDCS组采用tDCS真刺激进行治疗,假刺激组采用tDCS假刺激治疗。分别在治疗前、治疗5 d后及治疗4周后对两组患者行蒙特利尔认知评估量表(MoCA)、数字符号转换测验(SDMT)、30项Boston命名量试验中文版(BNT)、数字广度测试(顺背和倒背)(DS-forward、DS-backword)、事件相关电位P300检查,观察P300波幅、潜伏期。结果tDCS组治疗5 d、4周后的SDMT、BNT、DS-forward、DS-backword分值高于本组治疗前,差异有统计学意义(P<0.05)。tDCS组治疗5 d、4周后的SDMT、BNT、DS-forward、DS-backword分值高于假刺激组同期,差异有统计学意义(P<0.05)。tDCS组治疗5 d、4周后的P300波幅高于本组治疗前,潜伏期低于本组治疗前,且tDCS组患者治疗5 d、4周后的P300波幅高于假刺激组,潜伏期低于假刺激组,差异有统计学意义(P<0.05)。tDCS组治疗5 d后与治疗前的P300波幅差值与SDMT、BNT、DS-forward、DS-backword的差值呈正相关(r=0.354、0.392、0.349、0.381,P<0.05)。tDCS组治疗5 d后与治疗前的潜伏期差值与SDMT、BNT、DS-forward、DS-backword的差值呈正相关(r=0.432、0.464、0.365、0.342,P<0.05)。结论tDCS可以改善MCI患者的工作记忆,效果可持续4周,安全性高,事件相关电位P300的变化提示了tDCS能促进大脑功能的变化。Objective To investigate the effect of transcranial direct current stimulation(tDCS)on working memory in patients with mild cognitive impairment(MCI).Methods A total of 70 patients with MCI admitted to Wuxi Mental Health Center from January 2021 to December 2022 were selected as the study subjects,and they were divided into false stimulation group(n=35)and tDCS group(n=35)by random number table method.The tDCS group was treated with tDCS true stimulation,and the false stimulation group was treated with tDCS false stimulation.Before treatment,and 5 days after treatment and 4 weeks after treatment,the Montreal cognitive assessment(MoCA),symbol digital modalities test(SDMT),Boston naming test(BNT),digital span(forward and backward)(DS-forward,DS-backword)and event-related potential P300 were performed in both groups.P300 amplitude and incubation period were observed.Results The scores of SDMT,BNT,DS-forward and DS-backword in tDCS group after 5 days and 4 weeks of treatment were higher than those before treatment,and the differences were statistically significant(P<0.05).SDMT,BNT,DS-forward and DS-backword scores in tDCS group after 5 days and 4 weeks of treatment were higher than those in false stimulation group at the same period,and the differences were statistically significant(P<0.05).The P300 amplitude after 5 days and 4 weeks of treatment in tDCS group were higher than those before treatment,and the latency were lower than those before treatment,and the P300 amplitude after 5 days and 4 weeks of treatment in tDCS group were higher than those in false stimulation group,and the latency were lower than those in false stimulation group,with statistical significances(P<0.05).The P300 amplitude difference between the tDCS group after 5 days of treatment and before treatment was positively correlated with the difference of SDMT,BNT,DS-forward and DS-backword(r=0.354,0.392,0.349,0.381,P<0.05).The latency difference between the tDCS group after 5 days of treatment and before treatment was positively correlated with th

关 键 词：经颅直流电刺激 轻度认知功能障碍 事件相关电位 蒙特利尔认知评估量表 

分 类 号：R74[医药卫生—神经病学与精神病学]