经颅磁刺激对阿尔茨海默病认知功能障碍的研究进展

Progress of transcranial magnetic stimulation on cognitive function in Alzheimer’s disease

阿尔茨海默病(Alzheimer’s disease,AD)是一种慢性进行性发展的中枢神经系统变性疾病,是老年人中最常见的认知障碍类型。重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)作为一种安全的无创脑刺激技术,目前有大量研究证明其可用于改善AD的认知功能。本文检索了近十年关于rTMS对AD认知功能治疗的机制和临床研究。目前rTMS对AD患者认知功能疗效的机制尚不明确,研究主要集中在调节突触可塑性、调节基因与蛋白表达、抑制细胞凋亡与调节血流再分布等方面,临床研究人群主要集中在轻中度和AD和轻度认知功能障碍患者,通过神经心理测评量表评估其语言、记忆等认知方面的改变。本文对此做一综述发现高频rTMS对AD的语言、记忆、学习能力等认知领域有改善作用,但仍需扩大样本量、扩展研究人群种类及研究广度、延长随访时间以进一步验证rTMS对AD患者认知功能的作用。

Alzheimer’s disease(AD),a chronic progressive degenerative disease of the central nervous system,is the most common type of cognitive impairment in the elderly.As a safe and non-invasive brain stimulation technique,repetitive transcranial magnetic stimulation(TMS)has been proved to be effective in improving cognitive function of AD by a large number of studies.This paper reviews the mechanism and clinical studies of rTMS in the treatment of cognitive function of AD in the past decade.The rTMS on cognitive function in patients with AD is unclear,the mechanism of curative effect research mainly focus on regulating synaptic plasticity,regulate gene and protein expression,inhibition of cell apoptosis and regulate blood flow redistribution,etc.,clinical research groups have focused on patients with mild-to-moderate and AD and MCI,through neuropsychological assessment scale to assess their language,memory and other cognitive changes.This paper made a review and found that high-frequency rTMS can improve the cognitive areas of AD,such as language,memory and learning ability.However,it is still necessary to expand the sample size,study population type and scope,and extend the follow-up time to further verify the effect of rTMS on the cognitive function of AD patients.