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经颅超声刺激联合认知康复对脑卒中后认知障碍的影响及其机制。

The effects and mechanisms of transcranial ultrasound stimulation combined with cognitive rehabilitation on post-stroke cognitive impairment.

机构信息

The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China.

Department of Rehabilitation Medicine, Nan'ao People's Hospital of Dapeng New District, Shenzhen, 518121, China.

出版信息

Neurol Sci. 2022 Jul;43(7):4315-4321. doi: 10.1007/s10072-022-05906-2. Epub 2022 Feb 10.

Abstract

OBJECTIVE

To investigate whether transcranial ultrasound stimulation (TUS) could improve post-stroke cognitive impairment (PSCI) and the potential mechanisms through which this can be achieved.

METHOD

Sixty patients with PSCI were selected and randomly divided into a control and observation group, respectively, with 30 cases in each group. Conventional cognitive rehabilitation training combined with TUS intervention was conducted in the observation group, while conventional cognitive rehabilitation training and sham-TUS stimulation were given to patients in the control group.

RESULTS

The Mini-Mental State Exam, Modified Barthel Index score, P300 latency, and wave amplitude, as well as the serum brain-derived neurotrophic factor (BDNF) levels, were significantly higher in both groups after treatment compared with those before treatment (P < 0.05), and were significantly higher in the observation group than in the control group (P < 0.05). After treatment, the observation group had significantly higher scores in executive, nomination, attention, language, and delayed recall compared with the control group (P < 0.05).

CONCLUSION

Transcranial ultrasound stimulation combined with conventional cognitive rehabilitation therapy improved the PSCI condition with better efficacy than conventional cognitive rehabilitation therapy only. The mechanism involved may be correlated with the upregulation of BDNF and P300 induced by TUS.

摘要

目的

探讨经颅超声刺激(TUS)是否能改善卒中后认知障碍(PSCI),以及实现这一目标的潜在机制。

方法

选取 60 例 PSCI 患者,随机分为对照组和观察组,各 30 例。观察组采用常规认知康复训练联合 TUS 干预,对照组采用常规认知康复训练联合假 TUS 刺激。

结果

治疗后两组患者的简易精神状态检查量表(MMSE)、改良巴氏指数评分、P300 潜伏期和波幅以及血清脑源性神经营养因子(BDNF)水平均明显高于治疗前(P<0.05),且观察组明显高于对照组(P<0.05)。治疗后观察组患者的执行、命名、注意、语言和延迟回忆等评分明显高于对照组(P<0.05)。

结论

经颅超声刺激联合常规认知康复疗法改善 PSCI 的效果优于单纯常规认知康复疗法。其机制可能与 TUS 诱导的 BDNF 和 P300 上调有关。

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