摘要
目的 探讨经颅交流电刺激(transcranial alternating current stimulation, tACS)对阿尔茨海默病(Alzheimer's disease, AD)患者脑血流量(cerebral blood flow, CBF)的影响。方法 回顾性分析2019年9月至2022年4月首都医科大学宣武医院神经内科记忆门诊及病房诊治的轻度AD患者21例,接受3周tACS治疗,基线(T_(0)期)、完成即刻(T_(1)期)和3个月(T_(2)期)分别进行简易智能状态检查量表(mini-mental state examination, MMSE)评分、听觉词语学习测验(auditory verbal learning test, AVLT)评分和磁共振成像数据采集,CBF图z变换(z-transform CBF,zCBF)减少个体差异,分析tACS治疗前后MMSE、AVLT评分以及脑zCBF、CBF的变化,采用Spearman相关性分析zCBF、CBF与认知功能评分的关系。结果 与T_(0)期比较,AD患者T_(1)期MMSE评分明显增加[22.00(20.00,25.00)分vs 20.00(18.00,21.50)分,P<0.01]。基于体素分析显示,与T_(0)期比较,AD患者T_(1)期双侧额叶及颞叶皮质zCBF明显增加,T_(2)期右侧额叶及颞叶皮质zCBF明显增加(P<0.05)。zCBF增加最明显的脑区位于右侧岛叶。基于感兴趣区分析显示,与T_(0)期比较,AD患者T_(1)期右侧额叶及颞叶皮质zCBF、CBF明显增加,差异有统计学意义(P<0.05)。T_(1)期右侧额叶皮质CBF改变值与AVLT评分延迟再认改变值呈正相关(r=0.617,P=0.005),T_(2)期左侧额叶皮质CBF改变值与MMSE评分改变值呈正相关(r=0.596,P=0.012)。结论 磁共振成像三维动脉自旋标记可客观评价tACS治疗后AD患者CBF变化,为评估tACS疗效提供可靠影像学指标。
Objective To investigate the effect of transcranial alternating current stimulation(tACS)on cerebral blood flow(CBF)in patients with Alzheimer's disease(AD).Methods A retrospective study was conducted on 21 mild AD patients admitted in our hospital from September 2019 to April 2022.All of them received tACS treatment for 3 weeks.Mini-mental state examination(MMSE),auditory verbal learning test(AVLT)and MRI were applied to obtain the data at baseline(T_(0)),the end of the treatment(T_(1))and in three months after treatment(T_(2)).Z-transform CBF(zCBF)was performed to reduce individual variability.The changes in MMSE and AVLT scores,as well as brain zCBF and CBF values before and after tACS treatment were analyzed.Spearman correlation analysis was used to examine the relationship of zCBF and CBF with cognitive scores.Results In the AD patients,their MMSE score was significantly increased at T_(1) than at T_(0)[22.00(20.00,25.00)vs 20.00(18.00,21.50),P<0.01].Based on voxel analysis,the AD patients exhibited significantly increased zCBF in the bilateral frontal and temporal cortex at T_(1),and in the right frontal and temporal cortex at T_(2) when compared with the levels at T_(0)(P<0.05).The most pronounced increase in zCBF was observed in the right insular.Based on region of interest analysis,increased zCBF and CBF in the right frontal and temporal cortex at T_(1) were observed(P<0.05).There was a positive correlation between the change of CBF in the right frontal cortex and AVLT-recognition recall at T_(1)(r=0.617,P=0.005)and between the change of CBF in the left frontal cortex and MMSE at T_(2)(r=0.596,P=0.012).Conclusion MRI 3D-ASL can objectively evaluate the changes of CBF in AD patients after tACS treatment,and it provides a reliable imaging marker for evaluating the efficacy of tACS.
作者
王涛
闫少珍
薛寒笑
席晗予
齐志刚
唐毅
卢洁
Wang Tao;Yan Shaozhen;Xue Hanxiao;Xi Hanyu;Qi Zhigang;Tang Yi;Lu Jie(Department of Radiology and Nuclear Medicine,Beijing Key Laboratory of Magnetic Resonance Imaging Brain Informatics,Xuanwu Hospital,Capital Medical University,Capital Medical University,Beijing 100053,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2024年第11期1315-1319,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家自然科学基金(82394434)
国家重点研发计划项目(2022YFC2406900)。
关键词
阿尔茨海默病
经颅交流电刺激
脑血管循环
磁共振成像
Alzheimer disease
transcranial alternating current stimulation
cerebrovascular circulation
magnetic resonance imaging
