使用双靶向经颅磁刺激、单靶向经颅磁刺激或假经颅磁刺激治疗脑卒中后认知障碍

IF 2.5 4区 医学 Q3 NEUROSCIENCES Journal of integrative neuroscience Pub Date : 2024-08-23 DOI:10.31083/j.jin2308161
Bingshan Xu, Chunrong Lin, Yiwen Wang, Hong Wang, Yao Liu, Xiaojun Wang
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引用次数: 0

摘要

背景:尽管10赫兹重复经颅磁刺激(rTMS)在增强大脑皮层兴奋性和改善认知功能方面的有效性已得到证实,但其临床应用仍然有限。本研究使用了一个新的刺激靶点 [左侧背外侧前额叶皮层 + 初级运动皮层],通过双向促进认知和运动功能来提高认知功能;方法:脑卒中后认知障碍患者(n = 48)被随机分配接受双靶点、单靶点或假经颅磁刺激治疗 4 周。在接受治疗 4 周之前和之后,参与者需要完成蒙特利尔认知评估(MoCA)测试、改良巴特尔指数(MBI)、寻迹测试(TMT)和数字跨度测试(DST)。此外,还测量了血清中脑源性神经营养因子(BDNF)和血管内皮生长因子(VEGF)的水平:经调整干预前(基线)MoCA评分后,干预后的MoCA评分差异显著。经过事后分析,双靶向经颅磁刺激组和假经颅磁刺激组的治疗后得分存在差异(实验组得分明显更高),双靶向经颅磁刺激组和单靶向经颅磁刺激组的治疗后得分也存在差异(双靶向经颅磁刺激组得分明显更高)。双目标经颅磁刺激组的血清血管内皮生长因子水平明显高于假经颅磁刺激组:本研究提供的数据显示,双靶向经颅磁刺激疗法对卒中后认知障碍(PSCI)有效。本研究数据显示,双靶点经颅磁刺激疗法对脑卒中后认知障碍(PSCI)有效,刺激效果显著,表明双靶点刺激(左侧背外侧前额叶皮层+运动皮层(L-DLPFC+M1))有望成为脑卒中后认知障碍患者接受经颅磁刺激疗法的潜在靶点:临床试验注册号:ChiCTR220066184。注册时间:2022年11月26日,https://www.chictr.org.cn。
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Using Dual-Target rTMS, Single-Target rTMS, or Sham rTMS on Post-Stroke Cognitive Impairment.

Background: The clinical application of 10 Hz repetitive transcranil magnetic stimulation (rTMS) remains limited despite its demonstrated effectiveness in enhancing cortical excitability and improving cognitive function. The present study used a novel stimulus target [left dorsolateral prefrontal cortex + primary motor cortex] to facilitate the enhancement of cognitive function through the bidirectional promotion of cognitive and motor functions; Methods: Post-stroke cognitive impairment patients (n = 48) were randomly assigned to receive either dual-target, single-target, or sham rTMS for 4 weeks. Before and after 4 weeks of treatment, participants were asked to complete the Montreal Cognitive Assessment (MoCA) test, the Modified Barthel Index (MBI), the Trail-making Test (TMT), and the Digital Span Test (DST). In addition, the levels of brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) in serum were also measured.

Results: After adjusting for pre-intervention (baseline) MoCA scores, the post-intervention MoCA scores varied significantly. After post-hoc analysis, differences existed between the post-treatment scores of the dual-target rTMS group and the sham rTMS group (the experimental group scores were significantly higher), and between those of the dual-target rTMS group and the single-target rTMS group (the dual-target rTMS scores were significantly higher). The serum VEGF levels of the dual-target rTMS group were significantly higher those that of the sham rTMS group.

Conclusions: The present study presented data showing that a dual-target rTMS therapy is effective for Post-stroke cognitive impairment (PSCI). The stimulation exhibited remarkable efficacy, suggesting that dual-target stimulation (left dorsolateral prefrontal cortex+motor cortex (L-DLPFC+M1)) holds promise as a potential target for TMS therapy in individuals with cognitive impairment after stroke.

Clinical trial registration: No: ChiCTR220066184. Registered 26 November, 2022, https://www.chictr.org.cn.

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来源期刊
CiteScore
2.80
自引率
5.60%
发文量
173
审稿时长
2 months
期刊介绍: JIN is an international peer-reviewed, open access journal. JIN publishes leading-edge research at the interface of theoretical and experimental neuroscience, focusing across hierarchical levels of brain organization to better understand how diverse functions are integrated. We encourage submissions from scientists of all specialties that relate to brain functioning.
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