| Objective:Explicit the efficacy and safety of high frequency repetitive transcranial magnetic stimulation(rTMS)on cognitive function of amnestic mild cognitive impairment(aMCI)patients with neuropsychology assessment scales;explore the intervention mechanism of rTMS through the BOLD signals on cognitive function based on resting-state functional magnetic resonance imaging(rs-fMRI)and provide relevant theoretic basis for the treatment of rTMS on aMCI.Method:22 participants with diagnostic criterias were recruited and randomly divided into two groups by real stimulation 13 cases and sham 9 cases.All participants were given rTMS,stimulated the left dorsolateral prefrontal(DLPFC),frequency of 10 Hz,80% rest motor threshold(RMT),2 seconds for stimulation,interval of 8 seconds,repeated 20 times.There were 5 times per week,last for 2 consecutive weeks.In the sham stimulation group,the stimulation site and parameters were the same as those in the real group,but the sham was performed in vertical;the side effects were observed at the same time;the resting state fMRI data of all patients were collected before and after the treatment.All patients were evaluated for cognitive function of Montreal cognitive assessment scale(MoCA)and Rivermead behavioral memory test(RBMT)before and after rTMS.The results of scales were analyzed by SPSS25.0 statistical software.The paired samples t test was used before and after treatment.The independent sample t test was used for comparison between the two groups.The fMRI data were analyzed by SPM12 software in matlab.Result 1.There is no statistical significance(P >0.05)among MoCA and RBMT between the real and the sham stimulation groups before rTMS.There were significant differences in MoCA and RBMT neuropsychological scores in the real stimulation group after rTMS(p<0.05).The difference in MoCA scores was statistically significant(p<0.05),and the RBMT neuropsychological scores were statistically different(p<0.05).There were no significant differences in the scores of MoCA and RBMT neuropsychological measures after pseudostimulation(p>0.05).2.In the experimental group after rTMS,the brain regions causing significant differences in ReHo values were concentrated in the right prefrontal lobe,right inferior frontal gyrus,and supraorbital gyrus;causing ALFF values Significantly enhanced brain regions are concentrated in: left occipital lobe,bilateral parietal lobe,right inferior frontal gyrus,anterior cranial lobes;brain regions causing significant reduction in ALFF values are concentrated in bilateral frontal lobe,mid-median,advanced Brain back.In the control group,there was no significant difference in brain area compared with that before high-frequency rTMS.The difference in efficacy(the difference between the true and the sham),compared with the sham-stimulated group,the real stimulation group activated by the high-frequency repetitive transcranial stimulation,the right parietal lobe,the right temporal lobe,the right sub-lower lobe,the right ankle Last time;the suppressed brain area has the right prefrontal lobe.3.During the MRI scan,1 patient developed dizziness and was not tolerated.Conclusion: 1.10 Hz rTMS can improve the cognitive function of aMCI patients to a certain extent.2.10 Hz of rTMS treatment are safe.3.rTMS can strengthen spontaneous activity of cognitive-related brain regions in rs-fMRI,synchronize neurons activities and improve cognitive function. |
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