宋梦涵,高呈飞,周锐志,等.经颅直流电刺激对脑卒中患者认知功能及其脑白质纤维完整性的影响[J].中华物理医学与康复杂志,2023,45(5):391-396
扫码阅读全文
|
| 经颅直流电刺激对脑卒中患者认知功能及其脑白质纤维完整性的影响 |
|
| |
| DOI：10.3760/cma.j.issn.0254-1424.2023.05.002 |
| 中文关键词: 脑卒中后认知障碍 经颅直流电刺激 弥散张量成像 脑白质纤维 |
| 英文关键词: Stroke Cognitive impairment Transcranial direct current stimulation Diffusion tensor imaging White matter fibers |
| 基金项目:山东省自然科学基金（ZR2021QH062） |
|
| 摘要点击次数: 1558 |
| 全文下载次数: 1445 |
| 中文摘要: |
| 目的 观察经颅直流电刺激(tDCS)对脑卒中患者认知功能的疗效，并利用磁共振弥散张量成像(DTI)技术观察tDCS对脑白质纤维完整性的影响。 方法 选取脑卒中后认知障碍(PSCI)患者30例，将其分为试验组和对照组，每组患者15例。2组患者均给予基础药物治疗和常规认知训练，试验组在此基础上增加tDCS治疗（每日1次，每次刺激20 min，每周刺激5 d，连续治疗3周），对照组则增加tDCS假刺激。于治疗前和治疗3周后（治疗后）采用简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评价2组患者的认知功能，其日常生活活动能力采用改良的Barthel指数(MBI)进行评估，同时采用DTI观察PSCI患者脑白质纤维完整性的变化，并采用Pearson检验法对弥散纤维束的FA值与MMSE、MoCA分数进行相关性分析。 结果 治疗后，2组患者的MMSE、MoCA、MBI评分较组内治疗前均显著改善，差异均有统计学意义（P<0.05），且试验组治疗后的MMSE、MoCA、MBI评分均显著高于对照组治疗后，差异均有统计学意义（P<0.05）。试验组患者治疗后的FA、DA、DR值与组内治疗前和对照组治疗后比较，差异均有统计学意义（P<0.05）。2组患者患侧IFOF的FA值与MMSE评分（r=0.8447，P<0.0001）和MoCA评分（r=0.6688，P<0.0001）均呈正相关。 结论 tDCS可以有效地提高脑卒中患者的认知功能、改善日常生活活动能力，其机制可能与tDCS可改善相关脑白质纤维的完整性有关。 |
| 英文摘要: |
| Objective To observe any effect of transcranial direct current stimulation (tDCS) on the cognition of stroke survivors and the integrity of their white matter fibers. Methods Thirty persons with post-stroke cognitive impairment (PSCI) were randomly divided into an experimental group (n=15) and a control group (n=15). In addition to basic drug therapy and routine cognition training, the experimental group received 20 minutes of tDCS daily, 5 days per week for 3 weeks, while the control group received sham tDCS stimulation. Before and after the treatment, both groups′ cognitive functioning was evaluated using the mini-mental state examination (MMSE) and the Montreal cognitive assessment scale (MoCA). Their ability in the activities of daily living (ADL) was quantified using the modified Barthel index (MBI). Diffusion tensor imaging (DTI) was employed to observe any changes in the integrity of their white matter fibers. Results The average MMSE, MOCA and MBI scores of both groups had improved significantly after the treatment, but the improvement in the experimental group was significantly greater than among the controls. The average fractional anisotroposy value of the affected inferior fronto-occipital fasciculus in both groups was positively correlated with the group′s average MMSE score and MoCA score. Conclusion tDCS can effectively improve the cognition and functioning in the activities of daily living of stroke survivors. Its mechanism may be related to improving the integrity of the white matter fibers involved. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
