) 1深圳大学脑疾病与认知科学研究中心
2深港脑科学创新研究院, 深圳 518060
收稿日期:2020-11-10出版日期:2021-11-15发布日期:2021-09-23通讯作者:关青E-mail:guanqing@szu.edu.cn基金资助:深圳市基础研究专项(自然科学基金)面上项目(JCYJ20190808121415365);广东省自然科学基金项目(2020A1515011394);国家自然科学基金面上项目(32071100);国家重点研发计划(2018YFC1315200)Effects of repetitive transcranial magnetic stimulation on patients with mild cognitive impairment
CHEN Juan1, HE Hao1,2, YANG Dandan1, GUAN Qing1,2() 1Center for Brain Diseases and Cognitive Sciences, Shenzhen University
2Shenzhen-Hong Kong Institute of Brain Science - Shenzhen Fundamental Research Institutions, Shenzhen 518060, China
Received:2020-11-10Online:2021-11-15Published:2021-09-23Contact:GUAN Qing E-mail:guanqing@szu.edu.cn摘要/Abstract
摘要： 轻度认知障碍(mild cognitive impairment, MCI)是介于正常认知老化和老年痴呆的中间状态, 目前尚无有效的药物治疗方案。重复经颅磁刺激(repetitive transcranial magnetic stimulation, rTMS)可通过诱导突触可塑性的改变来改善大脑的认知功能。对rTMS干预MCI认知功能的有效性及神经机制进行分析。未来研究应优化定位手段, 延长对干预效果的随访评估, 考察不同刺激参数和刺激靶区对干预有效性的影响, 以及结合脑成像技术来探索rTMS的干预机制。
图/表 3
图1文献筛选流程及结果
图1文献筛选流程及结果
图2纳入研究的偏倚风险比例
图2纳入研究的偏倚风险比例表1纳入研究的基本信息
| 作者(年份) | 样本量 | 刺激区域 | 频率, 强度(RMT), 总脉冲数/次 | 刺激疗程 | 定位方法 | 结局指标 | 所属认知域 |
|---|---|---|---|---|---|---|---|
| Anderkova et al., | 20 | 额下回, 颞上回 | 10 Hz, 90%, 2250 | 1次/天, 2天 | 神经导航 | 1, 2, 3 | 注意和认知加工速度 |
| Eliasova et al., | 10 | 右额下回 | 10 Hz, 90%, 2250 | 1次/天, 2天 | 神经导航 | 1, 2, 3, 28 | 注意和认知加工速度, 执行功能 |
| Taylor et al., | 99 | 背外侧前额叶, 顶叶 | 10 Hz, 120%, 4000 | 1次/天, 20天 | 神经导航 | 1, 2, 11, 17, 18, 27 | 执行功能 |
| Koch et al., | 14 | 楔前叶 | 20 Hz, 100%, 1400 | 1次/天, 5天/周, 2周 | 神经导航 | 7, 9 21, 22 | 情景记忆 |
| Marra et al., | 34 | 背外侧前额叶 | 10 Hz, 110%, 2000 | 1次/天, 5天/周, 2周 | 5 cm规则 | 20, 23, 24, 25 | 情景记忆 |
| 温秀云 等, | 43 | 左背外侧前额叶 | 10 Hz, 80%, 400 | 1次/天, 5天/周, 4周 | — | 17, 23 | 情景记忆 |
| Turriziani et al., | 8 | 背外侧前额叶 | 1 Hz, 90% /50 Hz, 80%, 600 | 共2次, 每次间隔 3周 | 神经导航 | 5 | 长时记忆 |
| 祝本菊 等, | 24 | 前颞区 | 1 Hz, 80%, 600 | 1次/天, 5天/周, 6周 | — | 4 | 长时记忆 |
| Cui et al., | 21 | 右背外侧前额叶 | 10 Hz, 90%, 1500 | 5天/周, 共2周 | 5 cm规则 | 1, 2, 7, 9, 19 | 短时记忆 |
| Cotelli et al., | 1 | 左顶下小叶 | 20 Hz, 100%, 2000 | 5天/周, 2周 | 神经导航 | 1, 2, 6-16 | 联想记忆 |
| Solé-Padullés et al., | 9 | 前额叶 | 5 Hz, 80%, 500 | 10 s刺激+20 s休息, 共5分钟 | — | 26 | 联想记忆 |
表1纳入研究的基本信息
| 作者(年份) | 样本量 | 刺激区域 | 频率, 强度(RMT), 总脉冲数/次 | 刺激疗程 | 定位方法 | 结局指标 | 所属认知域 |
|---|---|---|---|---|---|---|---|
| Anderkova et al., | 20 | 额下回, 颞上回 | 10 Hz, 90%, 2250 | 1次/天, 2天 | 神经导航 | 1, 2, 3 | 注意和认知加工速度 |
| Eliasova et al., | 10 | 右额下回 | 10 Hz, 90%, 2250 | 1次/天, 2天 | 神经导航 | 1, 2, 3, 28 | 注意和认知加工速度, 执行功能 |
| Taylor et al., | 99 | 背外侧前额叶, 顶叶 | 10 Hz, 120%, 4000 | 1次/天, 20天 | 神经导航 | 1, 2, 11, 17, 18, 27 | 执行功能 |
| Koch et al., | 14 | 楔前叶 | 20 Hz, 100%, 1400 | 1次/天, 5天/周, 2周 | 神经导航 | 7, 9 21, 22 | 情景记忆 |
| Marra et al., | 34 | 背外侧前额叶 | 10 Hz, 110%, 2000 | 1次/天, 5天/周, 2周 | 5 cm规则 | 20, 23, 24, 25 | 情景记忆 |
| 温秀云 等, | 43 | 左背外侧前额叶 | 10 Hz, 80%, 400 | 1次/天, 5天/周, 4周 | — | 17, 23 | 情景记忆 |
| Turriziani et al., | 8 | 背外侧前额叶 | 1 Hz, 90% /50 Hz, 80%, 600 | 共2次, 每次间隔 3周 | 神经导航 | 5 | 长时记忆 |
| 祝本菊 等, | 24 | 前颞区 | 1 Hz, 80%, 600 | 1次/天, 5天/周, 6周 | — | 4 | 长时记忆 |
| Cui et al., | 21 | 右背外侧前额叶 | 10 Hz, 90%, 1500 | 5天/周, 共2周 | 5 cm规则 | 1, 2, 7, 9, 19 | 短时记忆 |
| Cotelli et al., | 1 | 左顶下小叶 | 20 Hz, 100%, 2000 | 5天/周, 2周 | 神经导航 | 1, 2, 6-16 | 联想记忆 |
| Solé-Padullés et al., | 9 | 前额叶 | 5 Hz, 80%, 500 | 10 s刺激+20 s休息, 共5分钟 | — | 26 | 联想记忆 |
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