| 丁巧方,李哲,郭钢花,关晨霞,乐琳,郝道剑,李颖,范家宏,梁英姿,刘绵绵.不同频率重复经颅磁刺激对脑卒中后认知障碍患者的影响[J].中国康复,2019,34(10):513-517 |
| 不同频率重复经颅磁刺激对脑卒中后认知障碍患者的影响 |
| Effects of repetitive transcranial magnetic stimulation with different frequencies on cognitive impairment in stroke patients |
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| DOI： |
| 中文关键词: 重复经颅磁刺激 脑卒中 认知功能 |
| 英文关键词: Repetitive transcranial magnetic stimulation Stroke Cognitive function |
| 基金项目:河南省省直医疗机构医疗服务能力提升工程建设项目经费资助（豫财社【2017】149号） |
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| 中文摘要: |
| 目的：观察不同频率重复经颅磁刺激对脑卒中后认知障碍患者认知功能和功能独立性的临床疗效。方法：60例卒中后认知障碍患者随机分为高频组、低频组、联合组和对照组各15例。4组患者均进行基础药物治疗及康复训练，高频组患侧给予5Hz的rTMS，低频组健侧给予1Hz的rTMS，联合组患侧给予5Hz的rTMS后健侧给予1Hz的rTMS，对照组给予假刺激。在治疗前、治疗2周和治疗8周随访时分别采用MoCA量表筛查患者有无认知障碍，听觉事件相关电位P300检测患者认知功能情况，FIM量表评估患者认知功能及功能独立性。结果： 治疗2周和随访8周后，高频组、低频组和联合组MoCA评分明显高于治疗前和对照组(均P＜0.05)，2个时间点3组潜伏期低于治疗前，波幅和认知功能评分高于治疗前(均P＜0.05)；高频组和联合组潜伏期低于对照组、波幅更高(均P＜0.05)，且FIM总分高于治疗前(P＜0.05)；联合组MoCA评分和认知功能高于低频组和高频组(均P＜0.05)，且潜伏期比低频组更低、波幅更高(均P＜0.05)。治疗2周后，联合组认知功能评分和FIM总分比对照组更高（均P＜0.05）。8周随访后，低频组潜伏期低于对照组，波幅和认知功能评分更高(均P＜0.05)；联合组潜伏期比高频组更低、波幅更高，且运动功能评分高于低频组和高频组(均P＜0.05)；高频组和联合组运动功能高于治疗前，且FIM总分比治疗2周时更高(均P＜0.05)，2组运动、认知功能评分和FIM总分均高于对照组(均P＜0.05)；低频组和对照组FIM总分高于治疗前(均P＜0.05)。结论：联合经颅磁刺激治疗对认知功能及生活独立性的疗效比单一频率经颅磁刺激治疗出现早且持续效应显著。 |
| 英文摘要: |
| Objective: To observe the effects of different frequency repeated transcranial magnetic stimulation (rTMS) on cognitive function and functional independence measure (FIM) in patients with post-stroke cognitive impairment (PSCI). Methods: Sixty patients with PSCI were randomly divided into 5 Hz high frequency group, 1 Hz low-frequency group, 5 Hz + 1 Hz combined group and pseudo-stimulation treatment group, 15 cases in each group for 2 weeks. Montreal Cognitive Assessment Scale (MoCA), auditory Oddball stimulation sequence P300 and functional independence (FIM) were used to evaluate cognitive function and functional independence of patients before and 2 and 8 weeks after treatment. Result: After 2 weeks of treatment and 8 weeks of follow-up, MoCA scores in the high frequency group, the low-frequency group and the combined group were significantly higher than those before treatment and the control group (P<0.05), the incubation period in the 3 groups at 2 time points was shorter than that before treatment, and the amplitude and cognitive function scores were higher than those before treatment (P<0.05). The incubation period and amplitude in the high frequency group and the combined group were significantly reduced as compared with those in the control group (P<0.05), and the total score of FIM was higher than that before treatment (P<0.05). MoCA score and cognitive function score in the combined group were significantly higher than those in the low-frequency group and the high-frequency group (P<0.05), and the latency period was significantly shorter and the amplitude was significantly greater than those in the low-frequency group (P<0.05). After 2 weeks of treatment, the cognitive function score and FIM total score in the combined group were significantly higher than those in the control group (P<0.05). After 8 weeks of follow-up, the latency period in the low-frequency group was shorter than that in the control group, and the amplitude and cognitive function score were significantly higher (P<0.05). The combined group had lower latency and higher amplitude than in the high-frequency group, and the motor function score was significantly higher than in the low frequency group and the high frequency group (P<0.05). The motor function score in the high-frequency group and the combined group was significantly higher than that before treatment, and the total FIM score was significantly higher than that at 2nd week after treatment (P<0.05). The total FIM scores in low-frequency group and control group were significantly higher than those before treatment (P<0.05). Conclusion: The effect of combined magnetic stimulation therapy on cognitive function and life independence was earlier and more persistent than that of single frequency magnetic stimulation therapy. |
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