重复经颅磁刺激联合有氧运动训练对轻中度颅脑损伤后认知障碍患者认知功能的影响  

The effect of repetitive transcranial magnetic stimulation combined with aerobic exercise training on cognitive function in patients with cognitive impairment after mild to moderate traumatic brain injury

作　　者：陈文煜 毛显禹 章国伟[1] 郑贺彬 Chen Wenyu;Mao Xianyu;Zhang Guowei;Zheng Hebin(Department of Rehabilitation,Wenzhou Tcm Hospital of Zhejiang Chinese Medical Uniiversiity,Wenzhou,Zhejiang 325000,China)

机构地区：[1]浙江中医药大学附属温州市中医院康复科,浙江温州325000

出　　处：《中国微侵袭神经外科杂志》2025年第2期99-103,共5页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨轻中度颅脑损伤后认知障碍患者应用重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合有氧运动训练的治疗效果。方法采用随机数字表法将96例轻中度颅脑损伤后认知障碍患者分为对照组(采用有氧运动训练,n=48)与观察组(采用有氧运动训练联合rTMS治疗,n=48),两组均连续治疗12周。比较两组认知功能、脑血管血流速度、脑电图变化(P300波幅与P300潜伏期)、血清学指标、日常生活能力。结果观察组治疗后简易智力状态检查量表(mini-mental state examination,MMSE)、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评分、脑血管血流速度、P300波幅、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平及日常生活能力量表(activities of daily living scale,ADL)评分均高于对照组,P300潜伏期短于对照组,神经元特异性烯醇化酶(neuron specific enolase,NSE)水平低于对照组(均P<0.05)。结论轻中度颅脑损伤后认知障碍患者应用rTMS联合有氧运动训练,可促进脑损伤后神经功能恢复,改善认知功能、脑血流速度,提高日常生活能力,值得临床推广应用。Objective To investigate the therapeutic effect of repetitive transcranial magnetic stimulation(rTMS)combined with aerobic exercise training in patients with cognitive impairment after mild to moderate traumatic brain injury.Methods A total of 96 patients with mild to moderate cognitive impairment after traumatic brain injury were divided into control group(aerobic exercise training,n=48)and observation group(aerobic exercise training combined with rTMS,n=48)by random number table method,both of which were treated continuously for 12 weeks.Cognitive function,cerebral blood flow velocity,electroencephalogram changes(P300 amplitude and P300 latency),serological indicators,and activities of daily living were compared between the two groups.Results After treatment,the Mini-Mental State Examination(MMSE)score,Montreal Cognitive Assessment(MoCA)score,cerebral blood flow velocity,P300 amplitude,brain-derived neurotrophic factor(BDNF)level,and activities of daily living scale(ADL)score were higher in the observation group than in the control group.The P300 latency was shorter,and the neuron-specific enolase(NSE)level was lower in the observation group compared with the control group(all P<0.05).Conclusions The application of rTMS combined with aerobic exercise training in patients with cognitive impairment after mild to moderate traumatic brain injury can promote neurological function recovery and improve cognitive function,cerebral blood flow velocity,and enhance daily living abilities thus being worthy of wider clinical application.

关 键 词：颅脑损伤 认知功能障碍 经颅磁刺激 有氧运动训练 

分 类 号：R651.15[医药卫生—外科学]