摘要
目的探究重复经颅磁刺激(rTMS)结合言语听觉反馈训练对缺血性脑梗死患者认知功能与神经电生理的影响。方法收集2022年1月至2023年12月就诊于龙岩市第二医院康复科的80例脑梗死患者作为研究对象,其中男44例,女36例,年龄52~76岁,病程16~45 d。采用随机数字表法将患者分为对照组与观察组,每组40例。对照组接受语言听觉反馈训练,观察组在对照组基础上联合rTMS治疗。比较两组患者简易精神状态量表(MMSE)与蒙特利尔认知功能量表(MoCA)评分,脑血流动力学、神经电生理指标及日常生活能力(GQOLI-74和改良Barthel量表评分)。结果两组患者治疗后MMSE评分与MoCA评分均增加,且观察组治疗后MMSE评分和MoCA评分均高于对照组(P均<0.05)。两组患者治疗后大脑中动脉、大脑前动脉、大脑后动脉流速均增快,且观察组流速高于对照组(P<0.05)。两组患者治疗后运动诱发电位(MEP)振幅、P300波幅增高,中枢运动传导时间(CMCT)、P300潜伏期下降,且观察组MEP振幅、P300波幅高于对照组,CMCT、P300潜伏期低于对照组(P<0.05)。两组患者治疗后GQOLI-74评分与改良Barthel量表评分均升高,且观察组高于对照组(P<0.05)。结论rTMS联合言语听觉反馈训练有助于改善脑梗死患者的认知功能,改善脑血流动力学与神经电生理指标,提高患者日常生活能力。
Objective To explore the effects of repeated transcranial magnetic stimulation(rTMS)combined with speech and auditory feedback training on cognitive function and neuroelectrophysiology in patients with cerebral infarction.Methods A total of 80 patients with cerebral infarction admitted to the Rehabilitation Department of the Second Hospital of Longyan City from January 2022 to December 2023 were collected as the study objects,including 44 males and 36 females,aged 52-76 years,with a course of disease ranging from 16-45 days.Patients were divided into control group and observation group by random number table method,with 40 cases in each group.Patients in the control group received speech and auditory feedback training,and patients in the observation group were treated with rTMS on the basis of the control group.The scores of MMSE and MoCA,cerebral hemodynamics,neuroelectrophysiological indicators and ability of daily living(GQOLI-74 and modified Barthel scales)were compared between the two groups.Results MMSE and MoCA scores of both groups were increased after treatment,and which were higher in the observation group than those in the control group(P<0.05).After treatment,the flow velocity of middle cerebral artery,anterior cerebral artery and posterior cerebral artery increased in both groups,and the flow velocity in the observation group was higher than that in the control group(P<0.05).After treatment,the amplitude of motor evoked potential(MEP)and P300 amplitude increased,and the central motor conduction time(CMCT)and P300 latency decreased in the two groups,and the amplitude of MEP and the amplitude of P300 in the observation group were higher than those in the control group,while the CMCT and P300 latency were lower than those in the control group(P<0.05).The score of GQOLI-74 and modified Barthel scale were increased in both groups after treatment,and which were higher in the observation group than those in the control group(P<0.05).Conclusion rTMS combined with speech and auditory feedback training can improve the cognitive function of patients with cerebral infarction,improve cerebral hemodynamics and neuroelectrophysiological indexes,and enhance patients'daily living ability.
作者
陈海燕
Chen Haiyan(Department of Rehabilitation,the Second Hospital of Longyan City,Longyan City,Fujian Province,364000,China)
出处
《现代电生理学杂志》
2025年第2期74-77,82,共5页
Journal of Modern Electrophysiology
关键词
脑梗死
经颅磁刺激
认知功能障碍
电生理学
Brain infarction
Transcranial magnetic stimulation
Cognitive dysfunction
Electrophysiology
