间歇性θ波爆发刺激与认知训练联合应用对脑卒中后认知障碍的影响：一项单盲随机对照试验

Effects of Combined Use of Intermittent Theta Burst Stimulation and Cognitive Training on Poststroke Cognitive Impairment: A Single-Blind Randomized Controlled Trial.

作者信息

Zhang Youmei, Chu Minmin, Zheng Yanjun, Zhang Feilan, Yu Hong, Ye Xiancong, Xie Hangkai, Chen Jing, Qian Zhiyong, Zeng Chao, Chen Weihai, Pei Zhongcai, Zhang Yue, Chen Jianer

机构信息

From the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China (Youmei Z, Hangkai X, Jing C, Chao Z, Jianer C); The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China (Youmei Z, Yanjun Z, Hangkai X, Jing C, Chao Z, Jianer C); Zhejiang Rehabilitation Medical Center, Hangzhou, Zhejiang, China (Feilan Z, Hong Y, Xiancong Y, Jing C, Zhiyong Q, Chao Z, Jianer C); Beihang University, Hangzhou Innovation Institute, Hangzhou, Zhejiang, China (Weihai C, Zhongcai P, Yue Z); and The Seconditions Hospital of Anhui Medical University, Hefei, An hui, China (Minmin C).

出版信息

Am J Phys Med Rehabil. 2024 Apr 1;103(4):318-324. doi: 10.1097/PHM.0000000000002344. Epub 2023 Oct 17.

DOI:10.1097/PHM.0000000000002344

PMID:37792502

Abstract

OBJECTIVE

Poststroke cognitive impairment substantially affects patients' quality of life. This study explored the therapeutic efficacy of intermittent theta burst stimulation combined with cognitive training for poststroke cognitive impairment.

DESIGN

The experimental group received intermittent theta burst stimulation and cognitive training, whereas the control group only received cognitive training, both for 6 wks. The outcome measures were the Loewenstein Occupational Therapy Cognitive Assessment, modified Barthel Index, transcranial Doppler ultrasonography, and functional near-infrared spectroscopy.

RESULTS

After therapy, between-group comparisons revealed a substantial difference in the Loewenstein Occupational Therapy Cognitive Assessment scores ( P = 0.024). Improvements in visuomotor organization and thinking operations were more noticeable in the experimental group than in the other groups ( P = 0.017 and P = 0.044, respectively). After treatment, the resistance index of the experimental group differed from that of the control group; channels 29, 37, and 41 were activated ( P < 0.05). The active locations were the left dorsolateral prefrontal cortex, prefrontal polar cortex, and left Broca's region.

CONCLUSIONS

Intermittent theta burst stimulation combined with cognitive training had a superior effect on improving cognitive function and everyday activities compared with cognitive training alone, notably in visuomotor organization and thinking operations. Intermittent theta burst stimulation may enhance cognitive performance by improving network connectivity.

摘要

目的

卒中后认知障碍严重影响患者的生活质量。本研究探讨间歇性θ波爆发刺激联合认知训练对卒中后认知障碍的治疗效果。

设计

实验组接受间歇性θ波爆发刺激和认知训练，而对照组仅接受认知训练，均为期6周。结局指标包括洛文斯顿作业疗法认知评定、改良Barthel指数、经颅多普勒超声检查和功能性近红外光谱。

结果

治疗后，组间比较显示洛文斯顿作业疗法认知评定得分存在显著差异（P = 0.024）。实验组在视运动组织和思维操作方面的改善比其他组更明显（分别为P = 0.017和P = 0.044）。治疗后，实验组的阻力指数与对照组不同；29、37和41通道被激活（P < 0.05）。激活部位为左侧背外侧前额叶皮质、前额极皮质和左侧布洛卡区。