10 Hz重复经颅磁刺激对轻中度阿尔茨海默病患者的精神行为症状及注意执行的疗效观察

目的:观察高频重复经颅磁刺激(r TMS)对阿尔茨海默病患者的治疗作用。方法:选取临床诊断为轻中度阿尔茨海默病患者22例,随机分为治疗组12例和对照组10例。对照组予以假刺激治疗;治疗组予以真刺激治疗。r TMS治疗方法:频率10 Hz、强度为运动阈值100%、部位为左侧额叶背外侧,刺激时间5 s,间隔25 s,每序列50次脉冲、每天30个序列,共两周。两组在治疗前和治疗后(r TMS治疗后两周)均行MMSE、NPI、DST评分。结果:两组治疗前MMSE评分、NPI、DST评分差异无统计学意义(P>0.05);治疗后治疗组MMSE评分、NPI、DST评分差异有统计学意义(P<0.05);而对照组治疗前后比较均无统计学意义。结论:10 Hz r TMS刺激左侧额叶背外侧皮层对轻中度阿尔茨海默病患者的精神行为症状及注意执行有一定的康复作用。

Therapeutic effect of repetitive transcranial magnetic stimulation (10Hz) on BPSD and executive function in patients with mild to moderate Alzheimer's disease

Objective:The aim of this study was to observe the effect of high frequency repetitive transcranial magnetic stimulation (rTMS) on Alzheimer''s disease (AD),applied over the left dorsolateral prefrontal cortex (L-DLPFC).Methods:Twenty-two AD patients with mild to moderate cognitive impairment were randomly divided into two groups:treatment group(12 patients) and control group(10 patients).The treatment group were received with real rTMS (10 Hz,5s, interval of 25 s,100% motor threshold,and 1 500 pulses per day,one session daily for five consecutive days, for two weeks),whereas, the control group with sham stimulation.Mini Mental State Examination (MMSE),neuropsychiatric inventory questionnaire(NPI),Digit Span Test(DST) were assessed before and after the treatment.Data are analyzed by SPSS19.0 and Pared Test and Chi-square test.The measurement data is expressed by(x-±s).Results:The scales of MMSE,NPI,DST in the two groups before treatment had no significant difference (P>0.05).After 2 weeks of rTMS,the above-mentioned scales improved significantly in the treatment group(P<0.05),but with no statistical changes in the control group (P>0.05).Conclusion:10 Hz rTMS over left DLPFC might have a therapeutic effect on improving behavioral and psychological symptoms of dementia and executive function.