经颅直流电刺激改善基底节内囊区梗死患者注意力的疗效观察

Efficacy observation of transcranial direct current stimulation for improving the attention in patients with infarction in basal ganglia region

目的探讨经颅直流电刺激(tDCS)改善基底节内囊区梗死患者注意力的疗效。方法连续纳入2015年5月至2016年5月于南昌大学第一附属医院康复医学科就诊的60例基底节内囊区梗死患者,按照随机数字表法,随机分为对照组和试验组各30例。2组患者均接受常规康复训练,试验组同步行t DCS治疗,对照组行tDCS伪刺激。分别在干预前和干预4周后实施蒙特利尔认知评估量表(MoCA)、d2注意力测验和事件相关电位P300(ERP-P300)的测评与分析,并进行组间比较。结果干预前,两组患者各项评分差异均无统计学意义(均P>0.05)。干预后与干预前比较,试验组和对照组患者ERP-P300潜伏期缩短、波幅增高(均P<0.05),Mo CA量表总分[试验组:(22.7±2.7)分比(15.5±2.4)分;对照组:(17.2±2.5)分比(15.6±2.3)分]和注意维度评分[试验组:(4.6±1.2)分比(2.4±1.6)分;对照组:(3.6±1.5)分比(2.5±1.5)分]以及d2注意力测验任务完成总量、总成绩、集中程度评分[试验组:(295±31)分比(250±45)分,(279±38)分比(223±52)分,(97±22)分比(75±25)分;对照组:(276±33)分比(247±45)分,(257±39)分比(211±56)分,(84±23)分比(71±24)分]均提高(均P<0.05),且试验组患者各指标均优于对照组(均P<0.05)。结论 tDCS有助于改善基底节内囊区梗死患者的注意力。

Objective To investigate the efficacy observation of transcranial direct current stimulation（ tDCS） for improving the attention in patients with infarction in basal ganglia area. Methods Sixty consecutive patients with basal ganglia infarction admitted to the Department of Rehabilitation Medicine,the First Affiliated Hospital of Nanchang University from May 2015 to May 2016 were enrolled. They were randomly divided into either a control group or a test group according to the random number table（ n = 30 in each group）. The patients in both groups received routine rehabilitation training,and those in the test group received tDCS therapy synchronously,and the control group received the sham tDCS stimulation. The evaluations and analyses were conducted with the Montreal cognitive assessment（ MoCA）,d2 test of attention,and event-related potential-P300（ ERP-P300）,respectively in all patients before intervention and 4 weeks after intervention,and they were compared between the groups. Results There was no significant difference before intervention between the two groups（ all P〈0. 05）. Compared with before intervention,the ERPP300 latencies were reduced,the amplitudes were increased after intervention in the patients of the test group and the control group（ all P〈0. 05）. The MoCA total scores（ the test group： 22. 7 ± 2. 7 vs. 15. 5 ±2. 4; the control group： 17. 2 ± 2. 5 vs. 15. 6 ± 2. 3）,attention dimension scores（ the test group： 4. 6 ± 1. 2 vs.2. 4 ± 1. 6; the control group： 3. 6 ± 1. 5 vs. 2. 5 ± 1. 5）,and the total completion of d2 attention test task,total scores,and concentration degree scores（ the test group： 295 ± 31 vs. 250 ± 45,279 ± 38 vs. 223 ± 52,97 ± 22 vs. 75 ± 25; the control group： 276 ± 33 vs. 247 ± 45,257 ± 39 vs. 211 ± 56,84 ± 23 vs. 71 ± 24）were all increased（ all P〈0. 05）,and all the indexes of the test group were better than those of the control group（ all P〈0. 05）. Conclusion tDCS contributes to the improvement of the attention in patients with infarction in the internal capsule-basal ganglia region.