A Study On Effect Of Repetitive Transcranial Magnetic Stimulation And Computer-Based Cognitive Training In MCI

Objective To explore the effect of repetitive transcranial magnetic stimulation (rTMS) and Computer-Based Cognitive Training(CBCT) on mild cognitive impairment (MCI).Method27MCI patients were selected and divided into3groups randomly, they were rTMS group, CBCT group, rTMS+CBCT group. Meanwhile, selected9healthy volunteers as the normal control group(NC). The rTMS group with their routine medical treatment were administrated rTMS(at the bilateral temporal regions,1Hz,80%RMT,600pulses per day,5days per week,3weeks’ internal between the two courses,3courses together). For the CBCT group, besides their routine treatment,15-20minutes CBCT were given at the same time everyday(the CBCT contents focus on the memory and attention, four weeks a course,3courses together). For the CBCT+rTMS group, they were administrated both rTMS and CBCT besides their routine treatment, the same treatment parameter with rTMS group and CBCT group,3courses together. EEG, event-related potentials(ERP) P300and Clinical Memory Scale(CMS) were performed before and after therapy in all subjects.Result1The CMS memory quotient(MQ):After the treatment, MQ in every treatment group improved obviously with the comparison of the baseline(P<0.05); the treatment groups showed the higher MQ variation rate compared with the NC group(P<0.05).2The scores of subtests in CMS:After three-course treatment, the scores only in subtest of image free recall was obviously lower than the NC group(P<0.05). The scores in subtests of point-to memory, associative learning of CBCT group rise obviously after treatment(P<0.05); the associative learning of rTMS group improved obviously; the scores of rTMS+CBCT group in subtests of point-to memory, associative learning and recognition increased significantly compared with the baseline(P<0.05). NC group had lower scores in associative learning and image free recall than the baseline. Compared with the NC group, the variation rate of point-to memory, associative learning, image free recall and recognition in all treatment groups showed higher(P<0.05), and the CBCT+rTMS group gains the highest one of the three groups.3ERP:After treatment, the patients had significantly shorter latencies of P3oo(P<0.05), while the NC group was found nothing changed with significance. The variation rate of latencies of MCI patients were obviously higher than that in NC group. CBCT+rTMS group showed the highest rate of the treatment groups(P<0.05).4The LZC value of EEG:At the baseline, we found the values in the treatment groups were much lower than those in the NC group(P<0.05). After the three-course treatment, the differences of values no significance anymore(P>0.05). Compared with the rTMS group and the CBCT group, the CBCT+rTMS group’s value improved obviously, especially at FP1、F3、F7、F8、T3、T4、T5、The value of the CBCT group were also higher than the rTMS group, especially at F3、F7、T3.After the treatment, the improved LZC value of the treatment groups was found in at every channel with the comparison of the baseline, especially at FP1、FP2、F3、F4、F7、T3、T5in the CBCT group(P<0.05), while at F8、T4、T5、T6of the rTMS group(P<0.05), at FP1、 FP2、F3、F4、F7、F8、T3、T4、T5of the CBCT+rTMS group(P<0.05); as well as the bilateral frontal and temporal regions improved obviously(P<0.05).Conclusions1Both rTMS and CBCT can improve cognitive function in MCI patients.2rTMS combined with CBCT showed more effective improving in cognitive function compared with rTMS or CBCT.3The cognitive functional declining in MCI exits in the frontal and temporal earlier and more serious; and involves the other areas with the course of disease.4rTMS and CBCT can be a safe, effective method without side-effect for delaying the cognitive function decline.5In some degree, the memory ability suffered from declining with natural age in the normals, rTMS and CBCT could play a meaning role to resist normal aging.