tDCS预刺激增强脑卒中认知功能障碍患者认知康复疗效的临床研究

目的:探讨经颅直流电刺激(tDCS)预刺激联合认知训练对脑卒中认知功能障碍(PSCI)患者认知功能的影响。方法:脑卒中后认知功能障碍患者76例随机分为观察组和对照组各38例,2组均采用常规药物和康复训练,观察组先给予tDCS预刺激,再进行认知训练,对照组先行认知训练,再进行tDCS刺激。治疗前和治疗4周后,采用蒙特利尔认知功能评测量表(MoCA)、改良Barthel指数(MBI)、事件相关电位P300对患者进行评定。结果:治疗4周后,2组较治疗前的MoCA及MBI评均明显提高(均P<0.05),且观察组2项评分均高于对照组(均P<0.05);2组较治疗前的P300潜伏期均明显缩短(均P<0.05),波幅均明显增加(均P<0.05),且观察组2项指标均更优于对照组(均P<0.05)。结论:tDCS预刺激后给予认知训练方案对PSCI患者认知功能、ADL能力的改善作用优于先认知训练后tDCS刺激方案。

Controlled clinical improvement in cognition of priming transcranial direct current stimulation for post-stroke cognitive impairment

Objective:To investigate the clinical effect of transcranial direct current stimulation(tDCS)for poststroke cognitive impairment.Methods:Seventy-six patients with post-stroke cognitive dysfunction were randomly divided into the treatment group and the control group.Both groups were given conventional drugs and rehabilitation training.The treatment group was pre-stimulated with tDCS and then given cognitive training.The control group received cognitive training first and then tDCS stimulation.Before and after 4 weeks of treatment,the patients were evaluated using the Montreal cognitive function assessment scale(MoCA),modified Barthel index(MBI),and eventrelated potential(P300).Results:After 4 weeks of treatment,the MoCA and MBI ratings of the two groups were significantly higher than those before treatment(both P<0.05),and those in the treatment group were higher than in the control group(both P<0.05);The incubation period was significantly shortened(P<0.05),and the amplitudes were significantly increased(P<0.05),more significantly in the treatment group in the control group(P<0.05).Conclusion:The cognitive training program after tDCS pre-stimulation is better than the cognitive training tDCS stimulation program in improving the cognitive function and ADL of patients with post-stroke cognitive impairment.