| 王璐,朱永刚,朱秀华,曹雪丽,臧琳,陈志天.高频重复经颅磁刺激联合认知训练治疗卒中后执行功能障碍的疗效[J].中国康复,2023,38(9):515-519 |
| 高频重复经颅磁刺激联合认知训练治疗卒中后执行功能障碍的疗效 |
| Efficacy of high frequency repetitive transcranial magnetic stimulation combined with cognitive training in the treatment of executive dysfunction after stroke |
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| DOI： |
| 中文关键词: 脑卒中 重复经颅磁刺激 执行功能障碍 事件相关电位P300 |
| 英文关键词: stroke repetitive transcranial magnetic stimulation executive dysfunction event-related potential P300 |
| 基金项目:连云港市卫生健康面上科技项目（202103） |
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| 中文摘要: |
| 目的：探讨高频重复经颅磁刺激（rTMS）联合认知训练治疗卒中后执行功能障碍的疗效。方法：选取60例脑卒中后执行功能障碍患者，随机分成对照组和观察组各30例。对照组采用认知训练，同时给予假刺激治疗，观察组采用高频（10Hz）rTMS联合认知训练治疗，共治疗6周。2组患者于治疗前后采用额叶功能评定量表（FAB）、汉诺塔测试（TOH）、连线测验A(TMT-A)评定患者执行功能，同时评估事件相关电位P300潜伏期和波幅。结果：2组患者治疗前FAB评分、TOH评分、TMT-A评分、P300潜伏期及波幅的比较差异无统计学意义。治疗6周后，2组患者的FAB评分高于治疗前（P＜0.05），TOH评分及TMT-A评分低于治疗前（P＜0.05），P300潜伏期较治疗前缩短（P＜0.05），波幅较治疗前增高（P＜0.05）；治疗后，观察组FAB评分较对照组升高（P＜0.05），TOH及TMT-A评分较对照组降低（P＜0.05），P300潜伏期较对照组缩短（P＜0.05），P300波幅较对照组升高（P＜0.05）。结论：高频rTMS联合认知训练可以有效改善脑卒中患者的执行功能，P300可从神经电生理角度评估脑卒中患者的执行功能。 |
| 英文摘要: |
| Objective: To explore the efficacy of high frequency repetitive transcranial magnetic stimulation (rTMS) combined with cognitive training in the treatment of executive dysfunction after stroke. Methods: Totally, 60 patients with executive dysfunction after stroke were randomly divided into control group (n=30) and observation group (n=30). The control group was treated with cognitive training and sham stimulation, and the observation group was treated with high frequency (10 Hz) rTMS combined with cognitive training for 6 weeks. The executive function was assessed by frontal lobe function rating scale (FAB), Tower of Hanoi Test (TOH) and wiring Test A (TMT-A) before and after treatment, and the latency and amplitude of event-related potential P300 were evaluated at the same time. Results: There was no significant difference in FAB score, TOH score, TMT-A score, P300 latency and amplitude between the two groups before treatment. At 6th week after treatment, the FAB score of the two groups was higher, the TOH score and TMT-A score were lower, the latency of P300 was shorter, and the amplitude was higher than those before treatment. After treatment, the FAB score was higher, the TOH score and TMT-A score were lower in the observation group than those in the control group. The latency of P300 was shorter and the amplitude of P300 was higher in the observation group than those in the control group. Conclusion: High frequency rTMS combined with cognitive training can effectively improve the executive function of stroke patients. P300 can evaluate the executive function of stroke patients from the point of view of neuroelectrophysiology. |
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