重复经颅磁刺激联合认知功能训练治疗轻度认知功能障碍的疗效观察

Effect of repetitive transcranial magnetic stimulation combined with cognitive training on mild cognitive impairment

目的:观察重复经颅磁刺激(rTMS)联合认知功能训练对轻度认知功能障碍(MCI)患者认知功能改善作用。方法:MCI患者80例随机分为2组各40例,观察组采用rTMS治疗联合认知功能训练,对照组采用认知功能训练治疗。2组患者分别在治疗前后进行蒙特利尔认知评估量表(MoCA)评定及事件相关电位(ERP)P300检查。结果:治疗8周后,观察组MoCA量表各因子分及总分均明显高于治疗前及对照组(P<0.05,0.01);对照组MoCA量表各因子中视空间与执行、延迟回忆、语言、注意力、计算力、定向及总分均明显高于治疗前(P<0.05),命名及抽象力得分治疗前后比较差异无统计学意义。2组P300潜伏期均较治疗前明显缩短(P<0.05),且观察组P300潜伏期缩短更明显(P<0.05);2组波幅均较治疗前明显增高(P<0.05),且观察组增高幅度更大(P<0.05)。结论:重复经颅磁刺激联合认知功能训练对MCI患者的认知功能有明显的疗效,且明显优于单纯认知功能训练治疗。

Objective： To observe the effect of repetitive transcranial magnetic stimulation （rTMS） combined with cognitive training on cognitive function in patients with mild cognitive impairment （MCI）. Methods： Eighty patients with MCI were randomly divided into 2 groups, 40 cases in each group. The observation group was treated with rT- MS therapy combined with cognitive training, and the control group was treated with cognitive training alone. The patients in the two groups were assessed by the Montreal cognitive assessment scale （MoCA） and event related po- tential （ERP） P300 test before and after treatment. Results： After 8-week treatment, MOCA factor score and total scores of observation group were significantly higher than those before treatment and those of the control group （P〈0. 05, or 0. 01）. In control group, the scores of visual space, executive, delay memory, language, attention, calculation, orientation and total scores were significantly higher than those before treatment （P〈0. 05）, and the scores of naming and abstract ability had no statistically significant difference before and after treatment. The laten- cies of P300 in two groups were significantly shorter than those before treatment （P〈0. 05）, and those were signifi- cantly shorter in the observation group than in the control group （P〈0. 05）. The amplitudes of the two groups were significantly higher than those before treatment （P〈0. 05）, and the increased degree of the amplitudes in observa- tion group was significantly higher （P〈0. 05）. Conclusion： rTMS combined with cognitive function training has ob- vious effect on cognitive function of patients with MCI, and is superior to cognitive function training used alone.