虚拟现实技术联合计算机化认知训练干预对老年脑卒中患者认知功能的改善研究  

Improvement of cognitive function in elderly stroke patients by virtual reality combined with computerized cognitive training intervention

作　　者：周山虎 张鑫 刘慧晴 程伟 张仲锦 Zhou Shanhu;Zhang Xin;Liu Huiqing;Cheng Wei;Zhang Zhongjin(Department of Neurology,Wuhan Puren Hospital,Wuhan 430081,Hubei Province,China)

机构地区：[1]武汉市普仁医院神经内科,430081 [2]武汉市普仁医院康复医学科,430081

出　　处：《中华老年心脑血管病杂志》2025年第4期431-435,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：湖北省医学科研项目(2021W339)。

摘　　要：目的探讨老年脑卒中患者接受虚拟现实技术(virtual reality,VR)联合计算机化认知训练干预能否改善认知功能。方法选取2022年1月至2024年1月武汉市普仁医院神经内科收治的脑卒中患者202例,根据随机数表法分为实施传统认知训练干预的对照组101例和接受VR联合计算机化认知训练干预的研究组101例,持续干预3个月。比较2组干预前和干预后分别进行蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)、简易智能状态检查量表(mini-mental state examination,MMSE)、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)、Fugl-Meyer运动功能评价表(Fugl-Meyer assessment,FMA)、日常生活活动能力量表(activities of daily living,ADL)、多巴胺、神经肽Y(neuropeptide Y,NPY)、5-羟色胺(5-hydroxytryptamine,5-HT)、去甲肾上腺素(noradrenaline,NE)水平,并测定事件相关电位P300。结果2组干预后MoCA、MMSE、NPY、5-HT、NE、多巴胺、FMA、波幅显著高于干预前,差异有统计学意义(P<0.05)。研究组干预后MoCA[(27.64±0.62)分vs(26.83±0.65)分]、MMSE[(27.67±0.61)分vs(26.83±0.62)分]、NPY、5-HT、NE、多巴胺、FMA评分、波幅显著高于对照组,差异有统计学意义(P<0.01)。2组干预后NIHSS、ADL、潜伏期显著低于干预前,差异有统计学意义(P<0.05)。研究组干预后NIHSS、ADL、潜伏期显著低于对照组,差异有统计学意义(P<0.01)。结论老年脑卒中患者接受VR联合计算机化认知训练干预能够有效改善患者的认知功能、神经功能、运动功能、日常生活功能,提升神经递质水平。Objective To explore whether virtual reality(VR)combined with computerized cognitive training intervention can improve the cognitive function in elderly stroke patients.Methods A total of 202 stroke patients admitted to our department from January 2022 to January 2024 were recruited and randomly divided into control group(101 cases,traditional cognitive training intervention)and study group(101 cases,VR combined with computerized cognitive training intervention).Before and after 3 months of intervention,Montreal Cognitive Assessment Scale(MoCA),Mini-Mental State Examination(MMSE),National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FMA),Activities of Daily Living Scale(ADL)were applied,serum levels of dopamine,neuropeptide Y(NPY),5-hydroxytryptamine(5-HT)and norepinephrine(NE)were detected,and P300 wave of event-related potential was measured.The results were compared before and after intervention,and between the two groups.Results After intervention,the scores of MoCA,MMSE and FMA,the levels of NPY,5-HT,NE,dopamine,and the amplitude of P300 wave were obviously higher in both groups when compared with those before intervention(P<0.05).The study group obtained notably higher MoCA score(27.64±0.62 vs 26.83±0.65),MMSE score(27.67±0.61 vs 26.83±0.62),NPY,5-HT,NE,dopamine,FMA score and amplitude of P300 wave after intervention than the control group(P<0.01).The NIHSS score,ADL score and latency in the two groups after intervention were significantly lower than those before intervention(P<0.05),and the above indicators in the study group were significantly lower than the control group(P<0.01).Conclusion VR combined with computerized cognitive training intervention can effectively improve the cognitive function,neurological function,motor function and daily life function,and enhance the neurotransmitter levels in elderly stroke patients.

关 键 词：虚拟现实 卒中 认知 运动疗法 

分 类 号：R74[医药卫生—神经病学与精神病学]