Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Department of Neurology, People's Hospital of Deyang City, Deyang, China.
Disabil Rehabil. 2022 Dec;44(25):7958-7966. doi: 10.1080/09638288.2021.2004245. Epub 2021 Nov 17.
PURPOSE: To investigate the effect of two weeks of repetitive transcranial magnetic stimulation (rTMS) on the attention network in Parkinson's disease (PD) patients. MATERIALS AND METHODS: Sixty PD patients were randomly divided into equal-sized active- and sham-rTMS groups. Executive function was assessed by neuropsychological tests including the Trail-Making Test (TMT), word fluency test, digit span, Wisconsin Card Sorting Test (WCST) and Stroop test. The attention network was evaluated by the attention network test (ANT). rTMS (5 Hz) was applied over the left dorsolateral prefrontal cortex (DLPFC) in the active-rTMS group, and the sham-rTMS group underwent sham stimulation, both for two weeks. All tests were performed before and after rTMS. RESULTS: After active rTMS, nonparametric analysis revealed significant improvements in categories completed (CC) ( < 0.001) in the WCST and reaction times (RTs) in part 3 ( = 0.002) and the Stroop interference effect (SIE) ( < 0.001) in the Stroop test. Regarding the ANT, the RTs of the executive control network were significantly reduced ( < 0.001). There was no significant change after sham rTMS. CONCLUSIONS: In the short term, in PD patients, rTMS improved the executive control network involved in resolving conflicting information. However, it showed milder effects on neuropsychological test outcomes assessing executive function, which may involve different neuromechanisms.Implications for rehabilitationCognitive impairment is common in patients with Parkinson's disease (PD), and it is related to functional disability and reduced quality of life.Attention is a main component of the cognitive system, and attention deficits are responsible for disability.This study demonstrates that rTMS is beneficial for cognitive rehabilitation in PD, as patients showed improved performance on the attention network test and neuropsychological tests.
目的:探讨重复经颅磁刺激(rTMS)对帕金森病(PD)患者注意网络的影响。
材料与方法:将 60 例 PD 患者随机均分为真刺激组和假刺激组。采用神经心理学测试,包括连线测试(TMT)、词语流畅性测试、数字跨度、威斯康星卡片分类测试(WCST)和斯特鲁普测试,评估执行功能。采用注意网络测试(ANT)评估注意网络。在真刺激组中,将 rTMS(5Hz)应用于左侧背外侧前额叶皮质(DLPFC),假刺激组进行假刺激,均持续 2 周。所有测试在 rTMS 前后进行。
结果:在真刺激 rTMS 后,非参数分析显示 WCST 的完成分类数(CC)( < 0.001)和 WCST 第三部分的反应时(RT)( = 0.002)以及斯特鲁普干扰效应(SIE)( < 0.001)均有显著改善。在 ANT 方面,执行控制网络的 RT 明显降低( < 0.001)。假刺激 rTMS 后无显著变化。
结论:在短期治疗中,rTMS 可改善参与处理冲突信息的执行控制网络,对评估执行功能的神经心理学测试结果的影响较小,这可能涉及不同的神经机制。
康复意义:认知障碍在帕金森病(PD)患者中很常见,与功能障碍和生活质量下降有关。注意是认知系统的主要组成部分,注意缺陷是导致残疾的原因。本研究表明,rTMS 对 PD 的认知康复有益,因为患者在注意力网络测试和神经心理学测试中的表现均有所改善。
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