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经颅磁刺激联合计算机辅助认知训练对脑瘫伴认知障碍患儿认知功能的影响。

Effects of Transcranial Magnetic Stimulation Combined with Computer-Aided Cognitive Training on Cognitive Function of Children with Cerebral Palsy and Dysgnosia.

机构信息

Department of Rehabilitation, Qingdao Women and Children's Hospital, Qingdao, Shandong 266034, China.

出版信息

Comput Math Methods Med. 2022 Aug 26;2022:5316992. doi: 10.1155/2022/5316992. eCollection 2022.

Abstract

OBJECTIVE

This study is aimed at researching transcranial magnetic stimulation (TMS) effects combined with computer-aided cognitive training (CACT) on cognitive function of children suffering from cerebral palsy and dysgnosia.

METHODS

From December 2019 to October 2021, 86 children with cerebral palsy and dysgnosia who were treated at our hospital were recruited and assigned into observation and control groups ( = 43, each) using the random number table technique. The observation group received TMS combined with CACT (TMS+CACT), whereas the control group received only TMS. Chinese Wechsler Young Children Scale of Intelligence (C-WYCSI) and Chinese-Wechsler Intelligence Scale for Children (C-WISC) were used to evaluate the intelligence level of the two groups; Gross Motor Function Measure-88 (GMFM-88) of Fudan Chinese version was employed for evaluating the gross motor function of the two groups; a comparison was drawn among the two groups for the cerebral hemodynamic parameters before and after the treatment.

RESULTS

For young children, the verbal intelligence quotient (VIQ) scores at 6 and 12 weeks of treatment in the observation group were increased when compared to those in the control group (48.91 ± 3.70 vs. 47.32 ± 3.33, 54.25 ± 4.46 vs. 49.48 ± 3.36), and the observation group's performance intelligence quotient (PIQ) score at 12 weeks of treatment was higher as to that of the control group (65.38 ± 4.23 vs. 62.81 ± 4.74, all < 0.05). For older age children, the observation group's VIQ and PIQ scores were greater than the control group's at 6 and 12 weeks of treatment, with statistical significance (63.80 ± 3.76 vs. 59.50 ± 5.32, 74.64 ± 12.04 vs. 65.08 ± 6.30; 63.91 ± 5.96 vs. 58.42 ± 3.70, 72.73 ± 5.06 vs. 66.42 ± 5.93; all < 0.05). The GMFM-88 scale scores in both groups were increased after 6 and 12 weeks of treatment. After treatment for 12 weeks, the observation group's A-E scores were greater than those of the control group (all < 0.05). The peak systolic velocity ( ), end-diastolic velocity ( ), and mean velocity ( ) at the anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA) in the observation group were dramatically increased than those in the control group (all < 0.05) after 12 weeks of treatment.

CONCLUSION

TMS+CACT can effectively improve the intelligence level, cognitive ability, gross motor function, and cerebral blood flow of children suffering from cerebral palsy and intellectual disability.

摘要

目的

本研究旨在探讨经颅磁刺激(TMS)联合计算机辅助认知训练(CACT)对脑瘫伴智力障碍患儿认知功能的影响。

方法

选取 2019 年 12 月至 2021 年 10 月在我院治疗的 86 例脑瘫伴智力障碍患儿,采用随机数字表法将其分为观察组和对照组(每组 43 例)。观察组采用 TMS 联合 CACT(TMS+CACT)治疗,对照组仅采用 TMS 治疗。采用中国韦氏幼儿智力量表(C-WYCSI)和中国韦氏儿童智力量表(C-WISC)评估两组患儿的智力水平;采用复旦大学中文版粗大运动功能测量量表-88(GMFM-88)评估两组患儿的粗大运动功能;比较两组患儿治疗前后的脑血流动力学参数。

结果

对于幼儿,观察组治疗 6 周和 12 周时的言语智商(VIQ)评分高于对照组(48.91 ± 3.70 比 47.32 ± 3.33,54.25 ± 4.46 比 49.48 ± 3.36),观察组治疗 12 周时的操作智商(PIQ)评分高于对照组(65.38 ± 4.23 比 62.81 ± 4.74),差异均有统计学意义(均 <0.05)。对于年龄较大的儿童,观察组治疗 6 周和 12 周时的 VIQ 和 PIQ 评分均高于对照组,差异有统计学意义(63.80 ± 3.76 比 59.50 ± 5.32,74.64 ± 12.04 比 65.08 ± 6.30;63.91 ± 5.96 比 58.42 ± 3.70,72.73 ± 5.06 比 66.42 ± 5.93;均 <0.05)。两组患儿治疗 6 周和 12 周后 GMFM-88 量表评分均升高。治疗 12 周后,观察组 A-E 评分均高于对照组(均 <0.05)。观察组治疗 12 周后大脑前动脉(ACA)、大脑中动脉(MCA)和大脑后动脉(PCA)的收缩期峰值流速( )、舒张末期流速( )和平均流速( )均显著高于对照组(均 <0.05)。

结论

TMS+CACT 可有效提高脑瘫伴智力障碍患儿的智力水平、认知能力、粗大运动功能和脑血流。

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