高频重复经颅磁刺激对脑卒中恢复期患者认知功能的影响

Effects of high frequency repetitive transcranial magnetic stimulation on cognitive function in stroke patients in convalescent stage

目的观察高频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对脑卒中恢复期患者认知功能及日常生活活动能力(activities of daily living,ADL)的影响。方法将60例处于脑卒中恢复期且具有认知功能障碍的患者随机分为实验组(30例)和对照组(30例)。2组患者均予常规药物治疗及常规康复训练,实验组在此基础上予左前额叶背外侧区5 Hz rTMS治疗,对照组予左前额叶背外侧区假刺激,共治疗4周。治疗前、治疗4周后采用蒙特利尔认知评估量表评估认知功能,采用改良Barthel指数量表评估ADL。结果实验组和对照组患者的认知功能和ADL均在治疗4周后显著改善(P<0.05),且实验组患者认知功能提高的幅度显著高于对照组(P<0.05)。结论高频rTMS治疗可有助于改善脑卒中恢复期患者的认知功能及ADL。

Objective To observe the effects of repetitive transcranial magnetic stimulation(rTMS) on cognitive function and activities of daily living(ADL) in stroke patients in convalescent stage.Methods 60 patients with cognitive impairment in convalescent stage of stroke were randomly divided into experimental group(30 cases) and control group(30 cases).Both groups received conventional medicine treatment and rehabilitation training.For experimental group,5 HzrTMS was given at the left side of the dorsolateral prefrontal cortex for 4 weeks and for the control group,a sham treatment was given.Montreal cognitive assessment scale was used to assess cognitive function of patients and modified Barthel Index Scale was used to assess ADL of patients before and after 4 weeks of treatments.Results The cognitive function and ADL of the patients were significantly improved after 4 weeks of treatments in both experimental group and control group(P<0.05).The improvement of cognitive function and ADL of the experimental group was significantly higher than that of the control group after 4 weeks of treatments(P<0.05).Conclusion High frequency rTMS can improve the cognitive function and ADL of stroke patients in convalescent stage effectively.