目的 探讨重复经颅磁刺激(rTMS)治疗对老年轻度认知障碍(MCI)患者血清脑源性神经营养因子(BDNF)的影响。方法 选取2022-01至2023-10于武警陕西总队医院收治的老年MCI患者65例,随机数字表法分为治疗组(33例)和对照组(32例)。对照组口服银杏叶提取物(40 mg,3次/d)加rTMS假刺激治疗,治疗组口服银杏叶提取物(厂家、规格、用法用量同对照组)加rTMS治疗,两组均同时治疗原发病。分别在治疗前、治疗4周后测定两组血清BDNF,采用精神状态简易智力量表(MMSE)及蒙特利尔认知评估量表(MoCA)评分比较两组治疗前后疗效。结果 治疗后,治疗组MMSE[(24.58±1.64)vs. (22.50±1.34)]和MoCA评分[(24.03±1.51)vs.(22.03±1.28)]均高于对照组,治疗组治疗后MMSE[(24.58±1.64)vs.(22.97±1.78)]和MoCA评分[(24.03±1.51)vs.(21.88±1.75)]明显高于治疗前,差异均有统计学意义(P＜0.05);治疗后,治疗组血清BDNF水平高于对照组[(9.54±1.64)vs.(8.28±1.91)],治疗组治疗后血清BDNF水平高于治疗前[(9.54±1.64)vs.(7.93±1.62)],差异均有统计学意义(P＜0.05)。结论 血清BDNF水平与老年认知障碍有密切关系,rTMS治疗能升高老年MCI患者BDNF水平,改善认知功能,值得临床推广。
Abstract
Objective To observe the effect of repeated transcranial magnetic stimulation (rTMS) on serum brain-derived neurotrophic factor (BDNF) in elderly patients with mild cognitive impairment (MCI). Methods A total of 65 elderly patients with MCI who were admitted to Provincial Corps Hospital of Chinese People's Armed Police Force from January 2022 to October 2023 were included in the study, and divided into control group (n=32) and treatment group (n=33) by random number table method. In the control group,40mg of ginkgo biloba extract was taken orally (3 times/day) plus sham stimulation, while the treatment group received ginkgo biloba extract (manufacturer, specification, usage and dosage were the same as the control group) plus rTMS, and the primary disease was treated simultaneously in both groups. Serum BDNF was measured before treatment and 4 weeks after treatment, respectively, the clinical efficacy of the two groups before and after treatment was compared using the Simple Mental State Intelligence Scale (MMSE) and Montreal Cognitive Assessment Scale (MoCA) scores. Results After treatment, MMSE [(24.58±1.640) vs. (22.50±1.344)] and MoCA scores [(24.03±1.51) vs. (22.03±1.28)] in the treatment group were higher than those in the control group. MMSE [(24.58±1.64) vs. (22.97±1.78)] and MoCA [(24.03±1.51) vs. (21.88±1.75)] scores of the treatment group were significantly higher after treatment than those before treatment, and the differences were statistically significant (P＜0.05). After treatment, the serum BDNF level in the treatment group was significantly higher than that of the control group [(9.54±1.64) vs. (8.28±1.91)], and the serum BDNF level of the treatment group was higher than that before treatment [(9.54±1.64) vs. (7.93±1.62)], with statistically significant differences (P＜0.05). Conclusions Serum BDNF level is closely related to cognitive impairment in the elderly. rTMS therapy can increase the BDNF the level of BDNF in senile MCI patients and improve cognitive function, which is worthy of clinical promotion.
关键词
重复经颅磁刺激 /
老年人 /
认知功能 /
脑源性神经营养因子
Key words
repeated transcranial magnetic stimulation /
the elderly /
cognitive function /
brain-derived neurotrophic factor
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