背景:10Hz重复经颅磁刺激(rTMS)的临床应用仍然有限,尽管其在增强皮质兴奋性和改善认知功能方面已证明有效。本研究使用了一种新的刺激目标[左背外侧前额叶皮层+初级运动皮层],通过双向促进认知和运动功能来促进认知功能的增强;方法:中风后认知障碍患者(n=48)被随机分配接受双重目标,单目标,或假rTMS4周。治疗前后4周,参与者被要求完成蒙特利尔认知评估(MoCA)测试,修改后的Barthel指数(MBI),跟踪测试(TMT),和数字跨度测试(DST)。此外,同时测定血清中脑源性神经营养因子(BDNF)和血管内皮生长因子(VEGF)水平.
结果:调整干预前(基线)MoCA评分后,干预后MoCA评分差异显著.经过事后分析,双目标rTMS组与假rTMS组治疗后评分存在差异(实验组评分明显高于对照组),在双靶rTMS组和单靶rTMS组之间(双靶rTMS评分明显较高)。双靶点rTMS组血清VEGF水平明显高于假rTMS组。
结论:本研究提供的数据表明,双靶点rTMS治疗对卒中后认知障碍(PSCI)有效。刺激显示出显着的功效,提示双靶点刺激(左背外侧前额叶皮质+运动皮质(L-DLPFC+M1))有望成为卒中后认知障碍患者TMS治疗的潜在靶点.
背景:编号:ChiCTR220066184。11月26日登记,2022,https://www。chictr.org.cn.
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.
BACKGROUND: No: ChiCTR220066184. Registered 26 November, 2022, https://www.chictr.org.cn.