Effects of high frequency repetitive transcranial magnetic stimulation on cognitive function and white matter microstructure in mild cognitive impairment patients#br#
RAN Li1 GUO Zhiwei1 ZHOU Liang2 LI Zhongmei2 MU Qiwen1,2
1.Department of Radiology, the Second Affiliated Medical College of North Sichuan Medical College Nanchong Central Hospital, Sichuan Province, Nanchong 637000, China;
2.College of Clinical Medicine, Southwest Medical University, Sichuan Province, Luzhou 646000, China
Abstract Objective To study the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on cognitive function and white matter microstructure in patients with mild cognitive impairment (MCI). Methods A total of 29 MCI patients enrolled in the community of Nanchong City, Sichuan Province from January to July 2019 were divided into true stimulation group and pseudo stimulation group according to the random number table method, with 17 cases and 12 cases respectively. The true stimulation group was given 10 Hz rTMS for 10 days to stimulate the right dorsolateral prefrontal lobe (DLPFC); the pseudo stimulation group was given a pseudo stimulation coil. All subjects underwent the mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and diffusion tensor imaging (DTI) at baseline and after treatment. The above cognitive score and diffusion fractional anisotropy (FA) were compared, and analyze the correlation between cognitive score and FA value were analyzed. Results After treatment, the MoCA and MMSE scores of the true stimulation group were higher than those before the treatment, while the MoCA scores of the pseudo-stimulation group were higher than those before the treatment, and the differences were statistically significant (P ＜ 0.05); there was no statistically significant difference in the scores between the two groups after the treatment (P ＞ 0.05). In the true stimulation group, the FA values of the bilateral superior frontal gyrus and the right precuneus were higher than before treatment, and the FA values of the bilateral superior frontal gyrus, the precuneus, the right middle frontal gyrus, and the right parieto-occipital lobe were higher than those before the treatment. In the stimulation group, the FA values of the left hippocampus, thalamus, lingual gyrus, and middle temporal gyrus were lower than those in the pseudo-stimulation group, and the difference was statistically significant (P ＜ 0.05). The MMSE score of the true stimulation group was negatively correlated with the FA values of the left occipital lobe and hippocampus (r = -0.590, P = 0.013; r = -0.518, P = 0.034). Conclusion High-frequency rTMS therapy may regulate the white matter microstructure integrity of partially damaged brain regions in patients with MCI, and lead to the corresponding improvement in cognitive function.
RAN Li1 GUO Zhiwei1 ZHOU Liang2 LI Zhongmei2 MU Qiwen1,2. Effects of high frequency repetitive transcranial magnetic stimulation on cognitive function and white matter microstructure in mild cognitive impairment patients#br#[J]. 中国医药导报, 2021, 18(34): 143-147.
[1] Petersen RC，Lopez O，Armstrong MJ，et al. Practice guideline update summary：Mild cognitive impairment：Report of the Guideline Development，Dissemination，and Implementation Subcommittee of the American Academy of Neurology [J]. Neurology，2018，90（3）：126-135.
[2] Jia L，Du Y，Chu L，et al. Prevalence，risk factors，and management of dementia and mild cognitive impairment in adults aged 60 years or older in China：a cross-sectional study [J]. Lancet Public Health，2020，5（12）：e661-e671.
[3] 钱胜男，于明.预测轻度认知障碍向阿尔茨海默病转化的生物标志物的研究进展[J].中华神经医学杂志，2020， 19（5）：519-524.
[4] 杨青，贾杰.阿尔茨海默病相关指南及专家共识解读—全周期康复新视角[J].中国医刊，2021，56（1）：22-27.
[5] Lin Y，Jiang WJ，Shan PY，et al. The role of repetitive transcranial magnetic stimulation （rTMS） in the treatment of cognitive impairment in patients with Alzheimer’s disease：A systematic review and meta-analysis [J]. J Neurol Sci，2019，15（398）：184-191.
[6] 周亮，郭志伟，蒋炳虎，等.重复经颅磁刺激治疗轻度认知障碍疗效的Meta分析[J].中华物理医学与康复杂志，2020，42（6）：562-569.
[7] Chou YH，Ton That V，Sundman M. A systematic review and meta-analysis of rTMS effects on cognitive enhancement in mild cognitive impairment and Alzheimer’s disease [J]. Neurobiol Aging，2020，86：1-10.
[8] 孙祥茹，王效春，张辉，等.磁共振扩散成像技术在轻度认知障碍的研究进展[J].磁共振成像，2021，12（1）：70-72.
[9] Petersen RC. Clinical practice，Mild cognitive impairment [J]. N Engl J Med，2011，364（23）：2227-2234.
[10] 中国痴呆与认知障碍诊治指南写作组，杜怡峰，吕佩源，等.2018中国痴呆与认知障碍诊治指南（五）：轻度认知障碍的诊断与治疗[J].中华医学杂志，2018，98（17）：1294-1301.
[11] 刘畅.轻度认知障碍中神经心理学量表应用研究概况[J].世界最新医学信息文摘，2019，19（37）：94-95，98.
[12] 洪汉林，苏亚玲，苏嵘，等.MoCA和MMSE量表串联用于轻度认知障碍患者的筛查[J].中国老年学杂志，2018， 38（19）：4815-4817.
[13] Lara AH，Wallis JD. The Role of Prefrontal Cortex in Working Memory：A Mini Review [J]. Front Syst Neurosci，2015，9：173.
[14] Habib R，Nyberg L，Tulving E. Hemispheric asymmetries of memory：the HERA model revisited [J]. Trends Cogn Sci，2003，7（6）：241-245.
[15] 王思思，库逸轩.右侧背外侧前额叶在视觉工作记忆中的因果性作用[J].心理学报，2018，50（7）：727-738.
[16] 章礼勇，袁良津，王玉.重复经颅磁刺激对轻度认知功能障碍患者认知功能的影响[J].临床神经病学杂志，2014， 27（3）：203-206.
[17] 杨林霖，韩克艳，王学义，等.高频重复经颅磁刺激改善轻度认知障碍患者认知功能的初步分析[J].中华精神科杂志，2014，47（4）：227-231.
[18] Strafella AP，Ko JH，Monchi O. Therapeutic application of transcranial magnetic stimulation in Parkinson’s disease：the contribution of expectation [J]. Neuroimage，2006，31（4）：1666-1672.
[19] Jiang BH，He DM，Guo ZW，et al. Efficacy and placebo response of repetitive transcranial magnetic stimulation for primary insomnia [J]. Sleep Med，2019，63：9-13.
[20] Razza LB，Moffa AH，Moreno ML，et al. A systematic review and meta-analysis on placebo response to repetitive transcranial magnetic stimulation for depression trials [J]. Prog Neuropsychopharmacol Biol Psychiatry，2018，81：105-113.
[21] Shim G，Choi KY，Kim D，et al. Predicting neurocognitive function with hippocampal volumes and DTI metrics in patients with Alzheimer’s dementia and mild cognitive impairment [J]. Brain Behav，2017，7（9）：e00766.
[22] Chandra A，Dervenoulas G，Politis M，et al. Magnetic resonance imaging in Alzheimer’s disease and mild cognitive impairment [J]. J Neurol，2019，266（6）：1293-1302.
[23] Kumar A，Singh S，Singh A，et al. Diffusion tensor imaging based white matter changes and antioxidant enzymes status for early identification of mild cognitive impairment [J]. Int J Neurosci，2019，129（3）：209-216.
[24] Liu Y，Spulber G，Lehtimaki KK，et al. Diffusion tensor imaging and tract-based spatial statistics in Alzheimer’s disease and mild cognitive impairment [J]. Neurobiol Aging，2011，32（9）：1558-1571.
