健脑操对轻度认知功能障碍患者认知功能及精神行为症状的影响

Effect of brain exercise training on cognitive function and behavioral and psychological symptoms of patients with mild cognitive impairment

目的观察健脑操训练对轻度认知功能障碍(MCI)患者认知功能及精神行为症状的影响。方法将80例MCI患者随机分为干预组和对照组各40例,对干预组进行每周2次、每次45~60 min的健脑操训练,持续训练12周;分别于基线、3个月、6个月时对2组进行简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MOCA)、Zung焦虑自评量表(SAS)、Zung抑郁自评量表(SDS)、神经精神量表(NPI)、匹兹堡睡眠质量指数(PSQI)的评估。结果随访3个月和6个月时,对照组MMSE总分均较基线下降(P<0.001、P=0.007),注意力与计算力亚项分值也下降(P<0.001、P=0.009),语言能力亚项分值于随访6个月时也下降(P=0.012);干预组MMSE总分及其亚项分值各时间点比较差异均无统计学意义(P均>0.05)。对照组随访3个月和6个月时的MOCA总分均较基线下降(P=0.011、P<0.001),注意力与计算力亚项得分明显下降(P=0.002、P=0.048);干预组随访6个月时MOCA总分较基线增加(P=0.001),随访3个月和6个月时注意力与计算力亚项得分均较基线增加(P均<0.001),且此时2组注意力与计算力亚项得分比较差异均具有统计学意义(P均<0.001)。随访3个月和6个月时,对照组SAS分值均较基线增加(P=0.001、P=0.003),SDS分值也均较基线增加(P=0.002、P=0.007);而干预组于随访6个月时SDS分值较基线下降(P=0.009)。随访6个月时2组的SAS和SDS分值比较差异均具有统计学意义(P=0.002、P=0.016)。干预组和对照组NPI、PSQI分值无明显变化。结论健脑操训练可在一定程度上改善MCI患者认知功能、稳定情绪,在预防或延缓MCI患者向痴呆转化方面可能具有积极作用。

Objective To observe the effect of brain exercise training on cognitive function and behavioral and psychological symptoms of patients with mild cognitive impairment(MCI).Methods 80 patients with MCI were randomly divided into the intervention(n=40)and control groups(n=40).In the intervention group,brain exercise training was delivered for 45-60 min twice a week for 12 consecutive weeks.Mini-Mental State Examination Scale(MMSE),Montreal Cognitive Assessment(MoCA),Zung’s Self-rating Anxiety Scale(SAS),Zung’s Self-rating Depression Scale(SDS),Neuropsychiatric Inventory(NPI)and Pittsburgh Sleep Quality Index(PSQI)between two groups were evaluated at the baseline,3 months and 6 months,respectively.Results In the control group,the total MMSE scores at 3 and 6 months were significantly declined compared with the baseline value(P<0.001,P=0.007),the scores of attention and calculation domains were significantly decreased(P<0.001,P=0.009),and the score of language domain was also significantly declined at 6-month follow-up(P=0.012).No significant differences were observed regarding the total and each domain scores of MMSE at different time points in the intervention group(all P>0.05).In the control group,the total MoCA scores at 3-and 6-month follow-up were significantly lower than the baseline value(P=0.011,P<0.001),and the scores of attention and calculation domains were considerably declined(P=0.002,P=0.048).In the intervention group,the total MoCA score at 6 months was significantly higher than the baseline value(P=0.001),and the scores of attention and calculation domains at 3-and 6-month follow-up were considerably higher compared with the baseline values(both P<0.001),which significantly differed between two groups(both P<0.001).In the control group,the SAS scores at 3-and 6-month follow-up were significantly higher than the baseline values(P=0.001,P=0.003),the SDS scores at 3-and 6-month follow-up were also significantly higher compared with the baseline values(P=0.002,P=0.007).In the intervention group,the SDS score at 6 months was significantly lower than the baseline score(P=0.009).The SAS and SDS scores at 6-month follow-up significantly differed between two groups(P=0.002,P=0.016).No significant changes were observed in the NPI and PSQI scores between two groups.Conclusion Brain exercise training can improve the cognitive function and stabilize the mood of MCI patients to a certain extent,which might play a positive role in preventing or delaying the progression of MCI into dementia.