电刺激小脑顶核治疗不同程度血管性认知障碍的疗效研究

Clinical Effect of Cerebellar Fastigial Nucleus Electrical Stimulation in the Treatment of Vascular Cognitive Impairment of Varying Degrees

目的观察电刺激小脑顶核(FNS)在治疗不同程度血管性认知障碍(VCI)患者中的临床疗效。方法选取我院2009年1月—2011年6月60例VCI患者,包括非痴呆的血管性认知障碍(VCIND)患者(VCIND组)和血管性痴呆(VaD)患者(VaD组),每组各30例。所有患者在常规药物治疗基础上,采用FNS治疗。观察两组患者治疗前后事件相关电位-P300(ERP-P300)及蒙特利尔认知评估量表(MoCA)评分的情况,并进行比较。结果治疗后VCIND组患者MoCA评分、ERP-P300潜伏期及波幅与治疗前比较,差异均有统计学意义(t值分别为18.58、26.88、10.06,P<0.01)。治疗后VaD组患者MoCA评分、ERP-P300潜伏期及波幅与治疗前比较,差异亦均有统计学意义(t值分别为2.54、2.81、2.81,P<0.01)。两组患者MoCA评分、ERP-P300潜伏期及波幅治疗前后的差值比较,差异均有统计学意义(t值分别为9.81、20.12、30.16,P<0.01)。结论 FNS可改善VCI患者的认知功能,对VCIND患者更为有效。

Objective To investigate the clinical effects of cerebellar fastigial nucleus electrical stimulation（FNS） in the treatment of vascular cognitive impairment（VCI）of varying degrees.Methods 60 VCI patients admitted to our hospital from January 2009 to June 2011 were selected.The patients were divided into vascular cognitive impairment but no dementia（VCIND group） and vascular dementia（VaD group） with each group 30 cases.All the patients were given FNS treatment on the basis of conventional treatment.The event-related potentials P300（ERP-P300） and Montreal cognitive assessment（MoCA）of all patients were observed and compared before and after the treatment.Results After treatment,the scores of MoCA and the latency period and amplitude of ERP-P300 of the VCIND group showed statistically significant differences compared with those before the treatment（t=18.58,26.88,10.06,P0.01）.The scores of MoCA and the latency period and amplitude of ERP-P300 of the VaD group also showed statistically significant differences compared with those before the treatment（t=2.54,2.81,2.81,P0.01）.The differences of the scores of MoCA and the latency period and amplitude of ERP-P300 between VCIND group and VaD group were statistically significant（t=9.81,20.12,30.16,P0.01）.Conclusion FNS can improve cognitive function of VCI patients and is more effective for VCIND patients.