rTMS联合有氧和认知训练治疗小脑出血后认知障碍1例

rTMS Combined with Aerobic and Cognitive Training for Cognitive Impairment after Cerebellar Hemorrhage:A Case Report

小脑损伤不仅会影响运动和姿势控制,也可能导致记忆、视空间、执行功能等认知功能损害。本研究对1例小脑出血后认知障碍患者进行了综合治疗,包括高频rTMS联合有氧训练与计算机认知训练、延伸式认知训练,治疗前后应用简明精神状态检查、Rivermead行为记忆能力测验评估认知和记忆功能,使用改良Barthel指数量表、Lawton工具性日常生活能力量表评估日常生活能力。经过2个月的治疗,患者认知功能由中度损害、记忆功能重度损害逐步进展至正常水平,基本日常生活活动由中度功能障碍进展至独立,工具性日常生活活动由不能独立生活进展至改良性独立。

Cerebellar injury not only affects motor and postural control,but also may lead to impairment of cognitive functions such as memory,visuospatial,and executive functions.A patient with cognitive impairment after cerebellar hemorrhage accepted integrated interventions,including high-frequency rTMS,aerobic exercise,computer cognitive training,and extended cognitive training.Mini-mental state examination and Rivermead Behavioral Memory Test were used to assess her cognitive function,and Modified Barthel Index,Lawton instrumental activities of daily living were used to evaluate the activities of daily living(ADL)before and after interventions.After 2 months of treatment,the patient's cognitive function improved from moderate impairment to a normal level,and the memory function transitioned from severe impairment to a normal level.Furthermore,the patient’s Basic ADL progressed from moderate dysfunction to independence,and Instrumental ADL progressed from living dependently to adaptively independent.