高频重复经颅磁刺激在脑卒中后注意障碍患者中的临床研究

Clinical study of high frequency repetitive transcranial magnetic stimulation in patients with attention impairment after stroke

目的:探究高频重复经颅磁刺激(rTMS)对脑卒中后注意障碍患者的注意功能和事件相关电位的影响。方法:将60例卒中后注意障碍患者随机分为观察组和对照组各30例。2组患者均予以药物及常规康复治疗,在上述干预基础上观察组采用高频(10Hz)rTMS刺激,对照组予以rTMS假刺激。于治疗前及治疗4周后进行蒙特利尔认知评估量表(MoCA)、符号数字模式测试(SDMT)、数字广度测试(DST)、字母删除试验、事件相关电位P300的评定。结果:治疗后2组患者MoCA、SDMT、DST、正确删除数等评分均较治疗前提高(P<0.05),P300潜伏期缩短、波幅增高(P<0.05),观察组MoCA、SDMT、DST、字母正确删除数等评分较对照组提高更明显(P<0.05),P300潜伏期、波幅较对照组变化明显(P<0.05)。结论:高频rTMS可改善脑卒中后注意障碍患者的注意功能,P300可作为反映其注意功能受损的神经电生理指标。

Objective:To investigate the effects of high frequency repetitive transcranial magnetic stimulation(rTMS)on attention function and event-related potentials in patients with cognitive impairment after stroke.Methods:Sixty patients with attention impairment after stroke were randomly divided into an observation group and a control group,each of 30.Both groups were treated with drugs and routine rehabilitation training.The observation group was given high frequency(10 Hz)rTMS and the control group received sham rTMS stimulation.Both two groups were assessed by the Montreal Cognitive Assessment(MoCA),Symbol-Digit Modalities Test(SDMT),Digital span test(DST),Alphabet Deletion Test,Event-Related Potential P300 before and 4 weeks after the treatment.Results:After the treatment,the MoCA,SDMT,DST,and correct deletions scores of two groups were significantly higher than those before treatment(P<0.05),P300 latency was decreased,and amplitude was increased(P<0.05).The scores of MoCA,SDMT,DST and correct deletions in the observation group were increased significantly as compared with those in the control group(P<0.05)and the changes of P300 latency and amplitude were more obvious in the observation group(P<0.05).Conclusion:High frequency rTMS can improve the attention function of patients after stroke.P300 can be used as a neuroelectrophysiological index to reflect attention function.