近红外脑功能成像在重复经颅磁刺激治疗脑卒中后轻度认知功能障碍的应用

doi:10.3969/j.issn.1006-7795.2020.06.016

摘要/Abstract

摘要： 目的探讨高频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对脑卒中后轻度认知功能障碍以及前额叶氧合血红蛋白(oxyhemoglobin,Oxy-Hb)浓度的影响。方法选取脑卒中后轻度认知功能障碍患者60例,分为rTMS组(n=30)和对照组(n=30),两组均接受为期8周的常规康复训练,rTMS组同时接受15 Hz rTMS治疗。两组患者在治疗前(T0)、治疗4周(T1)和治疗8周后(T2)分别采用简易精神状态检查量表(Mini-mental State Examination,MMSE)、蒙特利尔认知评估量表(Montreal Cognitive Assessment Scale,MoCA)进行评估并接受近红外脑功能成像(functional near-infrared spectroscopy,fNIRS)测试。结果治疗后两组MMSE、MoCA评分及任务期Oxy-Hb浓度均有所升高,Oxy-Hb浓度达峰时间有所降低,治疗8周后(T2),rTMS组MMSE、MoCA评分以及任务期Oxy-Hb浓度均显著高于对照组(P＜0.01),rTMS组Oxy-Hb浓度达峰时间较对照组明显缩短(P＜0.01)。rTMS组患者任务期Oxy-Hb浓度与MMSE、MoCA评分存在正相关(P＜0.001)。结论高频rTMS对脑卒中后轻度认知功能障碍有一定的改善作用并能增加前额叶氧合血红蛋白浓度。

关键词: 脑卒中, 重复经颅磁刺激, 认知, 近红外脑功能成像

Abstract: Objective To explore the effects of high-frequency repeated transcranial magnetic stimulation (rTMS) on mild cognitive impairment and oxyhemoglobin concentration levels of prefrontal lobe in stroke patients. Methods Sixty patients with mild cognitive impairment after stroke were randomly divided into the rTMS group (n=30) and the control group (n=30). Both groups received 8 weeks of routine rehabilitation training,while the rTMS group received additionally 15 Hz rTMS during the treatment. Two groups of patients were assessed with the Mini-mental State Examination(MMSE) and the Montreal Montreal Cognitive Assessment (MoCA) before treatment (T0),4 weeks (T1) and 8 weeks (T2) after treatment. The patients were also examined with functional near-infrared spectroscopy (fNIRS). Results After 8 weeks of treatment(T2),MMSE,MoCA score, and the concentration of oxyhemoglobin in the rTMS group were significantly higher than those in the control group (P＜0.01),and the peak time of oxyhemoglobin concentration in the rTMS group was significantly shorter than that in the control group (P＜0.01). MMSE,MoCA score, and oxyhemoglobin concentration in the rTMS group after 8 weeks (T2) were significantly higher than that before treatment(T0)(P＜0.001). There was a positive correlation between MMSE,MoCA score, and oxyhemoglobin concentration (P＜0.001). Conclusion High-frequency rTMS improved mild cognitive impairment after stroke and increased the concentration of oxyhemoglobin in frontal lobe.

Key words: stroke, repetitive transcranial magnetic stimulation, cognition, functional near-infrared spectroscopy

中图分类号:

R743

张颖彬, 莫林宏, 聂忆秋, 刘爱贤. 近红外脑功能成像在重复经颅磁刺激治疗脑卒中后轻度认知功能障碍的应用[J]. 首都医科大学学报, 2020, 41(6): 965-969.

Zhang Yingbin, Mo Linhong, Nie Yiqiu, Liu Aixian. Application of functional near-infrared spectroscopy in the treatment of mild cognitive impairment after stroke with repeated transcranial magnetic stimulation[J]. Journal of Capital Medical University, 2020, 41(6): 965-969.

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