摘要
目的:观察重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对阿尔茨海默病(Alzheimer’s disease,AD)患者认知功能、神经精神行为症状及血浆微小核糖核酸-125b(microRNA-125b,miR-125b)、血浆磷酸化Tau-181蛋白(phosphorylated Tau181 protein,P-tau181)表达的影响。方法:筛选轻中度AD患者34例,随机分为对照组(n=16)和试验组(n=18)。对照组采取认知训练及重复经颅磁伪刺激,试验组采取认知训练结合重复经颅磁真刺激。磁刺激强度为100%的静息运动阈值,频率为10Hz,每日治疗1次,每周治疗5天,持续4周,刺激脑区为左侧前额叶背外侧区和左侧颞叶区。在治疗前、后进行Addenbrooke-Ⅲ认知检查(the AddenbrookeⅢcognitive examination,ACE-Ⅲ)、简易精神状态量表(mini-mental state scale,MMSE)及神经精神症状问卷(neuropsychiatric inventory,NPI)评估,并采用实时荧光定量聚合酶链式反应(realtime fluorescence quantitative polymerase chain reaction,qRT-PCR)技术检测微小miR-125b表达量,酶联免疫吸附测定(enzyme-linked immunosorbent assay,ELISA)技术检测P-tau181的浓度。结果:治疗结束后,试验组ACE-Ⅲ、MMSE和NPI评分以及miR-125b、P-tau181均较组内治疗前显著改善,差异具有显著性意义(P<0.05),且上述指标与对照组治疗后相比,差异具有显著性意义(P<0.05);而对照组各项指标改善不具有显著性意义(P>0.05)。结论:rTMS能改善轻中度AD患者的认知功能及神经精神行为症状,这可能与rTMS促进血浆miR-125b的表达和抑制P-tau181蛋白产生相关。
Objective:To observe the effects of repetitive transcranial magnetic stimulation(rTMS)on cognitive function,neuropsychiatric behavioral symptoms,expression of plasma microRNA-125b(miR-125b)and phosphorylated Tau181 protein(P-Tau181)of patients with Alzheimer's disease(AD).Method:Thirty-four patients with mild to moderate AD were screened and randomly divided into control group(n=16)and experimental group(n=18).The control group received cognitive training and repetitive transcranial magnetic pseudo-stimulation,and the experimental group received cognitive training and repetitive transcranial magnetic real stimulation.The magnetic stimulation intensity was 100%resting movement threshold(RMT),frequency was 10Hz.It's administered once a day,5 days a week for 4 weeks.The stimulation site were the left dorsolateral prefrontal lobe and left temporal lobe.The AddenbrookeⅢcognitive examination(ACE-Ⅲ),mini-mental state scale(MMSE)and neuropsychiatric inventory(NPI)were evaluated before and after treatment.The microRNA-125b expression was detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)and the concentration of P-Tau181 was determined by enzyme-linked immunosorbent assay(ELISA).Result:After treatment,the scores of ACE-Ⅲ,MMSE and NPI,miR-125b and P-Tau181 in the experimental group were significantly improved compared with those before treatment(P<0.05).There was no improvement of all indexes in the control group(P>0.05).Conclusion:rTMS improve the cognitive function and neuropsychiatric symptoms of patients with mild to moderate AD,which may be related to the promotion of plasma miR-125b expression and inhibition of P-Tau181 protein production by rTMS.It is worthy for clinical application.
作者
张凤霞
张旻
朱珊珊
ZHANG Fengxia;ZHANG Min;ZHU Shanshan(Renmin Hospital,Wuhan University,Wuhan,Hubei Province,430060)
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2024年第2期196-200,共5页
Chinese Journal of Rehabilitation Medicine
基金
中央高校基本科研业务费专项基金(2042021kf0140)
国家自然科学基金面上项目(81271406)。
