头皮针联合高频重复经颅磁刺激（rTMS）对脑瘫患儿认知功能的改善：一项前瞻性观察研究
Cognitive Improvement in Children With Cerebral Palsy Following Combined Scalp Acupuncture and High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS): A Prospective Observational Study.
作者信息
Shen Xiao Yu, Zhao Zhen Zhen, Huang Wei Yi, Zhong Jian Guo
机构信息
Rehabilitation, The Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital), Chengdu, CHN.
出版信息
Cureus. 2025 Jul 10;17(7):e87672. doi: 10.7759/cureus.87672. eCollection 2025 Jul.
OBJECTIVE
To evaluate the clinical efficacy of combining scalp acupuncture and high-frequency repetitive transcranial magnetic stimulation (rTMS) for improving cognitive function in children with cerebral palsy (CP) and cognitive impairment. Methods: In this prospective observational study, 60 children with CP and cognitive impairment were recruited from January 2023 to June 2024 at a tertiary rehabilitation center. Participants were divided into two groups (n=30 each): the observation group received scalp acupuncture plus high-frequency rTMS (3 sessions/week), while the control group received scalp acupuncture alone (same frequency). Both groups underwent concurrent routine rehabilitation (150 minutes/session, three sessions/week) for 24 weeks. Cognitive function was assessed using WISC-IV before and after intervention. Statistical analyses included t-tests, chi-square tests, and non-parametric tests.
RESULTS
Baseline characteristics (age, gender, and disease duration) showed no differences between the two groups (p>0.05). Pre-intervention, compared with the control group, total WISC scores were higher (64.74±4.00 vs. 60.07±4.54, p＜0.001), and a greater proportion of children with mild cognitive impairment (25/30 vs. 14/30, p=0.037) were in the observation group. Post-intervention, compared with the control group, total WISC scores were higher (75.03±4.72 vs. 65.90±4.81, p＜0.001), 65.90±4.81，p＜0.001), mean change scores were increased (10.57±2.81 vs. 5.83±1.70, p＜0.001), the Perceptual Reasoning Index was higher (82.26±7.62 vs. 74.16±10.31, p＜0.001), and the Working Memory Index was higher (78.90±7.12 vs. 67.33±7.70, p＜0.001) in the observation group.
CONCLUSION
The combination of scalp acupuncture and high-frequency rTMS significantly enhances cognitive function in children with CP and cognitive impairment compared to scalp acupuncture alone.
目的
评估头皮针联合高频重复经颅磁刺激（rTMS）改善脑瘫（CP）合并认知障碍患儿认知功能的临床疗效。方法：在这项前瞻性观察研究中，于2023年1月至2024年6月在一家三级康复中心招募了60例CP合并认知障碍患儿。参与者被分为两组（每组n = 30）：观察组接受头皮针加高频rTMS（每周3次），而对照组仅接受头皮针（相同频率）。两组均同时进行常规康复治疗（每次150分钟，每周3次），共24周。干预前后使用韦氏儿童智力量表第四版（WISC-IV）评估认知功能。统计分析包括t检验、卡方检验和非参数检验。
结果
两组的基线特征（年龄、性别和病程）无差异（p>0.05）。干预前，与对照组相比，观察组的WISC总分更高（64.74±4.00对60.07±4.54，p＜0.001），且观察组轻度认知障碍患儿的比例更高（25/30对14/30，p = 0.037）。干预后，与对照组相比，观察组的WISC总分更高（75.03±4.72对65.90±4.81，p＜0.001），平均变化得分增加（10.57±2.81对5.83±1.70，p＜0.001），知觉推理指数更高（82.26±7.62对74.16±10.31，p＜0.001），工作记忆指数更高（78.90±7.12对67.33±7.70，p＜0.001）。
结论
与单纯头皮针相比，头皮针联合高频rTMS可显著提高CP合并认知障碍患儿的认知功能。
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