Improving cognitive and psychological and behavioral symptoms in patients with mild to moderate vascular dementia by repetitive transcranial magnetic stimulation combined with cognitive function training
10.3760/cma.j.cn341190-20240204-00152
- VernacularTitle:rTMS联合认知功能训练改善轻中度VD患者认知与精神行为症状的临床研究
- Author:
Conghao SUN
1
;
Zheli CHEN
;
Xin JIN
;
Jinfeng FEI
;
Wanqiu NA
Author Information
1. 湖州市第三人民医院老年精神科，湖州 313000
- Keywords:
Dementia, vascular;
Transcranial magnetic stimulation;
Cognitive therapy;
Intelligence tests;
Activities of daily living;
Cysteine
- From:
Chinese Journal of Primary Medicine and Pharmacy
2024;31(9):1288-1294
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of repetitive transcranial magnetic stimulation combined with cognitive function training on improving cognitive and psychological and behavioral symptoms in patients with vascular dementia.Methods:A total of 80 patients with vascular dementia who received treatment at The Third People's Hospital of Huzhou from October 2020 to October 2022 were included in this study. They were divided into a control group and an observation group ( n = 40 per group) based on different treatment methods. The control group received repetitive transcranial magnetic stimulation, while the observation group received both repetitive transcranial magnetic stimulation and cognitive function training. Both groups were treated continuously for 4 weeks. The scores of The Mini-Mental State Examination (MMSE), the Behavioral Pathology in Alzheimer's Disease Rating Scale (BE-HAVE-AD), Activities of Daily Living (ADL), and Pittsburgh Sleep Quality Index (PSQI) of the two groups were analyzed before and after treatment. Additionally, serum levels of homocysteine and neuron-specific enolase in both groups were compared before and after treatment. The clinical efficacy of the two groups was evaluated, and the total response rate was calculated. Adverse reactions occurring during the treatment period in both groups were also recorded. Results:Before treatment, the Mini-Mental State Examination (MMSE) scores for the control and observation groups were (14.92 ± 2.43) points and (14.83 ± 2.56) points, respectively. After treatment, the scores were (22.81 ± 3.05) points for the control group and (25.62 ± 4.07) points for the observation group. After treatment, the MMSE scores in both groups were significantly higher than the respective levels before treatment in the corresponding group, and the observation group had a significantly higher score than the control group ( t = 2.25, P < 0.05). Before treatment, the BE-HAVE-AD scores for the control and observation groups were (45.28 ± 6.27) points and (44.95 ± 6.38) points, respectively. After treatment, the scores were (27.54 ± 2.22) points for the control group and (23.07 ± 1.79) points for the observation group. After treatment, the BE-HAVE-AD scores were significantly lower than those before treatment in each group, and the observation group had a significantly lower score than the control group ( t = 9.56, P < 0.05). Before treatment, the ADL scores for the control and observation groups were (23.17 ± 1.43) points and (22.83 ± 1.64) points, respectively. After treatment, the scores were (38.27 ± 3.25) points for the control group and (41.52 ± 4.26) points for the observation group. After treatment, the ADL scores in each group were significantly higher than their respective levels before treatment, and the observation group had a significantly higher score than the control group ( t = 3.83, P < 0.05). Before treatment, the PSQI scores for the control and observation groups were (16.423 ± 1.51) points and (15.86 ± 1.49) points, respectively. After treatment, the scores were (9.16 ± 1.12) points for the control group and (7.07 ± 1.07) points for the observation group. After treatment, the PSQI scores were significantly lower than those before treatment in each group, and the observation group had a significantly lower score than the control group ( t = 8.53, P < 0.05). Before treatment, the serum levels of homocysteine in the control and observation groups were (54.27 ± 8.21) ng/L and (55.13 ± 7.64) ng/L, respectively, while the serum levels of neuron-specific enolase in these two groups were (59.66 ± 9.51) μg/L and (60.97 ± 10.29) μg/L, respectively. After treatment, the serum levels of homocysteine in the control and observation groups were (30.63 ± 1.95) ng/L and (25.57 ± 2.06) ng/L, respectively, and the serum levels of neuron-specific enolase in these two groups were (49.23 ± 6.12) μg/L and (37.21 ± 7.01) μg/L, respectively. After treatment, the serum levels of homocysteine and neuron-specific enolase in each group were significantly lower than the respective levels before treatment in the corresponding group; the observation group exhibited significantly lower serum levels of homocysteine and neuron-specific enolase than the control group ( t = 11.28, 8.16, both P < 0.05). The total response rate in the observation group was 95.00% (38/40), which was significantly higher than that in the control group [72.50% (29/40), P < 0.05]. The incidence of adverse reactions in the observation group was 5.00% (2/40), which was significantly lower than that in the control group [20.00% (8/40), χ2 = 7.44, P < 0.05]. Conclusion:Repetitive transcranial magnetic stimulation combined with cognitive function training can more effectively improve cognitive and psychological and behavioral symptoms in patients with vascular dementia, has better efficacy, and is safer compared with repetitive transcranial magnetic stimulation alone.
