经颅磁刺激治疗阿尔茨海默病睡眠障碍的双盲、随机、假刺激对照初步研究
Transcranial magnetic stimulation for sleep disorders in Alzheimer's disease: A double-blind, randomized, and sham-controlled pilot study.
机构信息
Department of Neurology, Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China; Department of Neurology, China-Japan Friendship Hospital, Beijing, China.
Department of Neurology, China-Japan Friendship Hospital, Beijing, China; Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China.
出版信息
Neurosci Lett. 2022 Jan 1;766:136337. doi: 10.1016/j.neulet.2021.136337. Epub 2021 Nov 8.
BACKGROUND
Sleep disorders are commonly comorbid with Alzheimer's disease (AD), And these disorders interfere with each other in many aspects. To date, pharmacological treatments for sleep disorders are still limited, and studies investigating repetitive transcranial magnetic stimulation (rTMS) for sleep disorders in AD are still lacking.
METHOD
A single-center, randomized, double-blind, parallel-arm, and sham-controlled pilot study was conducted in AD patients with sleep disorders. Seventy subjects were randomly divided into the following two groups: the sham group (SG) and the intervention group (IG). We evaluated sleep changes using the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention. We also assessed the patients' cognitive function by the Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-Cog). The intervention period was four weeks, and the patients were followed up in the 8th week to test the persistence of the effect of the rTMS intervention.
RESULT
Significant differences in the PSQI scores were found between the SG and IG at the end of the 4-week intervention (P = 0.001) and the 8-week follow-up (P < 0.001). There was also significant improvement in ADAS-Cog scores (4 weeks: P = 0.048, 8 weeks: P = 0.038). Activities of daily living (ADL) did not significantly differ between the SG and IG.
CONCLUSION
rTMS can effectively ameliorate sleep disorders in AD patients.
背景
睡眠障碍通常与阿尔茨海默病（AD）共病，且这些障碍在许多方面相互干扰。迄今为止，针对睡眠障碍的药物治疗仍然有限，且针对 AD 患者睡眠障碍的重复经颅磁刺激（rTMS）研究仍较少。
方法
一项针对 AD 合并睡眠障碍患者的单中心、随机、双盲、平行臂、假刺激对照的初步研究。将 70 例患者随机分为假刺激组（SG）和干预组（IG）。我们使用匹兹堡睡眠质量指数（PSQI）在干预前后评估睡眠变化。我们还使用阿尔茨海默病评估量表认知部分（ADAS-Cog）评估患者的认知功能。干预期为四周，在第八周进行随访以测试 rTMS 干预效果的持久性。
结果
在四周干预结束时（P = 0.001）和八周随访时（P < 0.001），SG 和 IG 之间的 PSQI 评分差异具有统计学意义。ADAS-Cog 评分也有显著改善（4 周：P = 0.048，8 周：P = 0.038）。但日常生活活动（ADL）评分在 SG 和 IG 之间没有显著差异。
结论
rTMS 可有效改善 AD 患者的睡眠障碍。
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