| Objective： To observe the effects of transcranial direct current stimulation (tDCS) combined with cognitive training on the expression of cerebral metabolites in patients with post-stroke cognitive dysfunction. Methods： A total of 100 patients with post-stroke cognitive dysfunction admitted to our hospital from October 2019 to February 2021 were selected as the research objects. They were divided into control group and observation group by the random number table method. The control group was given cognitive training, and the observation group was given tDCS in addition to the treatment of the control group. The clinical efficacy, cognitive function, ability of daily living and expression level of neurometabolites before and after treatment were compared between the two groups. A random walking model was used to evaluate the improvement of cerebral neurometabolite expression in 2 groups after treatment. Results：The total effective rate in observation group ［84.00% (42/50)］ was significantly higher than that in control group ［62.00% (31/50)］(P<0.05). After treatment, the scores of MMSE, Montreal Cognitive Assessment Scale (MoCA), Modified Barthel Index (MBI) and Functional Independence Rating Scale (FIM) were significantly increased in 2 groups as compared with those before treatment (all P<0.05). Serum norepinephrine (NE), dopamine (DA) levels, 5-hydroxytryptamine (5-HT)/5-hydroxyindoleacetic acid (5-HIAA), ratio of 3, 4-dihydroxyphenylacetic acid (DOPAC)/vanillic acid (HVA), and ratio of N-acetylaspartic acid (rNAA) in brain of 2 groups after treatment were significantly increased as compared with those before treatment. The concentration of Lac/Cr in the brain was significantly decreased as compared with that before treatment, and the concentration of LAC/Cr in the observation group was significantly decreased as compared with that in the control group (all P<0.05). The results of random walking model showed that NE, DA, 5-HT/5-HIAA, DOPAC/HVA, rNAA and Lac/Cr in the observation group were significantly increased as compared with those in the control group. Conclusion： TDCS combined with cognitive training can significantly improve the cognitive function, daily behavior ability and therapeutic effect of patients with cognitive impairment after stroke, which may be related to the regulation of the expression of neurometabolites in the brain. |
