| Objectives: Based on the neuropsychology amount assessment of high frequency repetitive transcranial magnetic stimulation(r TMS) on the efficacy and safety after treatment in patients with amnestic mild cognitive impairment(a MCI).Then, this paper plans to explore the intervention mechanism of r TMS through the brain network of resting-state functional magnetic resonance imaging(f MRI) and provide relevant basis for the effectiveness of r TMS in the treatment of a MCI.Methods: 30 patients with diagnostic criteria are randomly divided into two groups by true or sham stimuli with 15 cases in each in this research. This research uses Montreal cognitive assessment scale(Mo CA) and clinical memory scale(CMS) to test every one. The CMS test results are converted into the memory quotient(MQ) with each test age scale as the observation index; true stimulating group is scanned by of resting state f MRI data in the 3.0T magnetic resonance environment, Structural magnetic resonance imaging(s MRI) was gathered in the false stimulation group while r TMS therapy was given to patients in the later two groups. The true stimulation group had 15 Hz and 100 % of resting motion threshold(RMT). The stimulating position was located in the left dorsolateral prefrontal cortex(dl PFC). All sequences were presented 50 times/per sequence, 20 sequences every day. The time interval was 25 seconds, 5 days as a course of treatment, and then 2 days of interval were taken for 2 courses of successive treatment; stimulating positions and parameters in the false stimulation group were same to the true stimulation group, but the false stimulation was given. Adverse reactions were observed at the meantime. The resting state f MRI data were collected in the true stimulation group at the end of treatment. All patients were performed the Montreal Cognitive Assessment(Mo CA) and clinical memory scale(CMS) test before and after treatment. CMS test results were converted into Memory Quotient(MQ) and each subtest age scale score was deemed as an observation index.After 2 courses of treatment, this research uses moca and cms to test, and scan the true stimulating group with FMRI. And this research analyzes the data by SPSS13.0 software and uses x—±s to show the measuring information. Before and after treatments, the two groups are compared by paired t test; and comparison between the two groups is tested by the independent samples t test. Lastly, this research gets the results of statistical analysis of FMRI by using SPM8 software, and does two sample t test on the seed point d LPFC as the function of network of region of interest(ROI) and whole brain voxel’s long distance function connection density and long term functional connectivity’s density connectivity to draw the graphics.Results:1 There is no statistical significance(P>0.05) among Mo CA, MQ, point-to memory, associative learning, image free recall, recognition of meaningless, Portrait character associated memory in the two groups before treatment. After the treatment, there is statistical significance(P<0.05) between directed memory neural amount and moca, but there is no statistical significance(P>0.05) among MQ, point-to memory, associative learning, image free recall, recognition of meaningless, Portrait character associated memory in the two groups. In addition, the percentage of Mo CA﹑MQ﹑point-to memory﹑associative learning﹑image free recall﹑recognition of meaningless is increased in true stimulating group after the treatment, among which there is statistical significance(P>0.05) among Mo CA and pm, the percentage of Portrait character associated memory was decreased, and there is no statistical significance(P>0.05). Compared with the pre-treatment, there is no statistical significance(P>0.05) among Mo CA, MQ, point-to memory, associative learning, image free recall, recognition of meaningless, Portrait character associated memory insham stimulation group.2 The left dl FPC for ROI f MRI functional connectivity result: after stimulation with r TMS, a MCI patients’ brain areas with dl PFC function connection was significantly increased are the left pre-central gyri, right middle frontal, left inferior frontal gyri, bilateral thalamus triangular part and bilateral inferior temporal gyri. The decreased areas include the right supplementary motor area, the left supramarginal gyri and right middle temporal gyri.3 The result of the true stimulating group’s long distance functional connectivity density before and after treatment: the increased areas of functional connectivity mainly refer to the bilateral cerebellum, bilateral opercular part inferior frontal gyrus, right superior parietal gyrus, right precuneus, the central sulcus, supramarginal gyrus, left cover on the right side of the right thalamus and right lateral temporal pole. The decreased areas of functional connectivity mainly refer to bilateral angular gyrus, bilateral posterior cingulate gyrus, left middle orbital frontal gyrus and bilateral middle temporal gyrus.4 One patient complained about slightly dizzy but tolerant after initial r TMS therapy. This symptom was eased within one hour and never come back again.Conclusion:1.High-frequency r TMS may improve the cognitive competence in a MCI patients to certain extent, especially significantly increased in Mo CA and memory scale scores.2.15HzrTMS treatment has no risk.3. the left dl FPC as ROI functional connectivity anomalies of a MCI patients appears in multiple brain regions after r TMS treatment, these changes may be the remodeling effects of r TMS on brain network, resulting in the improvement of cognitive function.4.after r TMS treatment, the difference of long distance functional connectivity proofs r TMS can influence and stimulate the related local and distant cortical function; also it can monitor the far-away area of the anatomic location. And the regulation of r TMS may contribute to the repair effect of the default network;Rtms may make some brain regions’ competitive depression in certain functions. |
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