郑雪,王甜甜,苏通,等.重复经颅磁刺激对脑小血管病患者认知功能和日常生活活动能力的影响[J].中华物理医学与康复杂志,2025,47(1):31-35
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| 重复经颅磁刺激对脑小血管病患者认知功能和日常生活活动能力的影响 |
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| DOI：10.3760/cma.j.cn421666-20240328-00216 |
| 中文关键词: 脑小血管病 重复经颅磁刺激 认知功能 日常生活活动能力 |
| 英文关键词: Cerebral small vessel disease Transcranial magnetic stimulation Cognition Activities of daily living |
| 基金项目:江苏省科技智库计划项目（JSKXKT 2024056）；连云港市卫生科技项目（201916） |
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| 中文摘要: |
| 目的 探讨重复经颅磁刺激（rTMS）对脑小血管病患者认知功能和日常生活活动（ADL）能力的影响。 方法 选取脑小血管病认知障碍患者71例，按照随机数字表法将其分为对照组（35例）和治疗组（36例）。根据MMSE评分，将治疗组细分为轻度认知障碍（21～26分）和中度认知障碍（10～20分）2个亚组，其中轻度认知障碍组23例，中度认知障碍组13例。治疗组采用10 Hz的rTMS治疗，对照组给予假rTMS。治疗前、治疗结束后90 d（治疗后），采用简易精神状态量表（MMSE）和血管性痴呆评估量表（VaDAS-cog）评定患者的认知功能，用Barthel指数（BI）评定患者的ADL能力。 结果 2组患者治疗后MMSE评分增加、VaDAS-cog评分降低、BI评分增加（P＜0.05）。与对照组比较，治疗组治疗后的MMSE评分［(25.61±2.94)分］较高、VaDAS-cog评分［(44.06±3.41)分］较低、BI评分［(80.00±7.85)分］较高（P＜0.05）。轻度认知障碍组和中度认知障碍组治疗后MMSE评分均较治疗前提高，但亚组间差异无统计学意义（P＞0.05）。患者rTMS治疗过程中均无严重不良反应。 结论 10 Hz的rTMS可有效改善脑小血管病患者的认知障碍，提高其ADL能力。 |
| 英文摘要: |
| Objective To explore the effect of repetitive transcranial magnetic stimulation (rTMS) on the cognition and ability in the activities of daily living (ADL) of persons with cerebral small vessel disease. Methods A total of 71 patients with cognitive impairment due to cerebral small vessel disease were randomly divided into a control group (n=35) and a treatment group (n=36). The treatment group was further divided into a group with mild cognitive impairment (a score of 21 to 26 on the mini-mental state exam, n=23) and a moderate cognitive impairment group (scoring 10 to 20, n=13). The treatment groups received 10Hz rTMS, while the control group received sham rTMS. Before and after 90 days of treatment, all were assessed using the mini-mental state examination (MMSE) and the cognitive subscale of the vascular dementia assessment scale (VaDAS-cog). Ability in the activities of daily living was quantified using the Barthel Index (BI). Results After treatment, significantly increased MMSE and BI scores, but significantly decreased VaDAS-cog scores were observed in both groups. At that point the treatment group showed a significantly higher average post-treatment MMSE score (25.61±2.94) and BI score (80.00±7.85), but a significantly lower average VaDAS-cog score (44.06±3.41) than the control group. The average MMSE scores were not significantly different between the mild and moderate cognitive impairment subgroups. No severe adverse reactions were observed during the rTMS treatment. Conclusions The 10Hz rTMS can effectively improve the cognition and daily living ability of persons with cerebral small vessel disease. |
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