经皮迷走神经刺激在失忆性轻度认知障碍中的应用研究

IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Age and ageing Pub Date : 2024-09-30 DOI:10.1093/ageing/afae178.021
Helena Dolphin, Adam H Dyer, Tim Dukelow, Ciaran Finucane, Amparo Zamora Gomollo, Sean Commins, Sean P Kennelly
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引用次数: 0

摘要

背景轻度认知功能障碍(MCI)患者急需新的治疗方法,尤其是那些患有失忆性 MCI 的患者,其中很大一部分人患有潜在的阿尔茨海默病(AD)。经皮迷走神经刺激疗法(tVNS)是一种非侵入性神经调节疗法,目前尚未对患有失忆性 MCI 的老年人进行广泛研究。方法 在地区专业记忆服务机构进行了一项急性(60 分钟)tVNS(基线、假刺激或主动刺激)单点、单盲、随机三臂交叉试验。试验招募了 40 名确诊为失忆性 MCI 的参与者(年龄为 71.7 ±6.9; 22/40 男性)。鉴于注意力缺失症与神经-心血管不稳定性之间的联系,研究人员利用外周(血压 (BP) 和心率 [HR])和中枢(通过近红外光谱)血流动力学对主动站立 (AS) 的逐次反应评估了主动 tVNS 的潜在不良影响。在 21.3 ±4.9 分钟和 60.5 ±4.4 分钟之间,使用特定领域的认知能力电池对认知能力进行评估,并使用混合效应线性回归对结果进行分析。结果 在患有失忆性 MCI 的老年人中,tVNS 是安全、可耐受和可接受的,98% 的参与者表示会再次使用该设备。对血压或心率的反应没有明显影响,大脑缺氧在 AS 期间保持稳定。刺激 tVNS 后,与基线(ß= -8.76;[-14.91,-2.56];p=0.01)和假刺激(ß= -4.15;[-7.32,-0.99];p=0.01)条件相比,空间导航测试的成绩明显提高。结论 tVNS 对患有失忆性 MCI 的老年人是一种安全、可耐受的治疗方式。未来的研究应探讨其持续效果和在家中使用的可行性。
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Investigating Transcutaneous Vagus Nerve Stimulation in Amnestic Mild Cognitive Impairment
Background New treatments are urgently needed for individuals with Mild Cognitive Impairment (MCI) - in particular for those with amnestic MCI, of whom a high proportion have underlying Alzheimer's Disease (AD). Transcutaneous Vagus Nerve Stimulation (tVNS) is a non-invasive neuro-modulatory treatment which has not been extensively examined in older adults with amnestic MCI. Methods A single site, single-blind, randomised three-arm crossover pilot trial of acute (60 minutes) tVNS (baseline, sham or active stimulation) was conducted a Regional Specialist Memory Service. Forty participants (age 71.7 ±6.9; 22/40 male) with diagnosed amnestic MCI were recruited. Given the links between AD and neuro-cardiovascular instability, potential adverse effects of active tVNS were assessed using beat-to-beat peripheral (Blood Pressure (BP) and Heart Rate [HR]) and central (via Near Infra-red Spectroscopy) haemodynamic responses to Active Stand (AS). Cognition was assessed between 21.3 ±4.9 and 60.5 ±4.4 minutes using a domain-specific cognitive performance battery with results analysed using mixed-effects linear regression. Results In older adults with amnestic MCI, tVNS was safe, tolerable and acceptable with 98% of participants stating they would use the device again. There was no significant effect on BP, or HR responses to AS and cerebral oxygenation remained stable during AS. After tVNS stimulation, performance on tests of spatial navigation were significantly improved compared to both baseline (ß= -8.76; [-14.91, -2.56]; p=0.01) and sham (ß= -4.15; [-7.32, -0.99]; p=0.01) conditions. Conclusion tVNS is a safe and tolerable treatment modality in older adults with amnestic MCI. Future studies should explore sustained effects and feasibility of domiciliary use.
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来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
期刊介绍: Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.
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