Efficacy Of Repeated Transcranial Magnetic Stimulation Combined With Rehabilitation Training In Patients With Non - Dementia Vascular Cognitive Impairment

Objective To explore the effect of repetitive transcranial magnetic stimulation(r TMS) combined with rehabi-litation training on cognitive function in patients with vascular cognitive impairment no dementia(VCIND).Methods Sixty patients with VCIND were randomly divided into an r TMS group and a control group according to a random number table,each of 30 cases.Both groups were given routine drug treatment(control the blood pressure and blood sugar, regulate the metabolism of lipid, doing nerve-nurturing and circulation improvement therapy) and the rehabilitation training(physical therapy,occupational therapy and cognitive training),the r TMS group were additionally given r TMS by the CCY-I transcranial magnetic stimulator. The frequency of the stimulation was 10 Hz,applied over the left dorsolateral prefrontal cortex(DLPFC), within 3000 Pulses per day and an individual motor threshold of 100%.We set five days as a course of treatment and there were two days between the course. There were totally four course in our treatment. Each patients was examined with mini-mental state examination(MMSE),the Montreal cognitive assessment(Mo CA) and Modified Barthel Index(MBI) to assess the cognitive function and the ability of daily life(ADL)before and after the four weeks of treatment. At the same time,latency and amplitude of P300 of the patients were measured.Results Before the treatment,the comparison of P300 latency and amplitude,MMSE, Mo CA, and MBI score-s of two groups were no statistically significant difference(P>0.05). After the treatment,the P300 latency and amplitude of two groups were better than before treatment(P<0.05).Compared with the control group, the P300 latency of the r TMS group was significantly shorten[(344.48±20.10)ms](P<0.05) and the amplitude was si-gnificantly heighten[(8.49±1.49)μV](P<0.05). After treatment,the Cognitive Assessment Scale scores of Mo CA,MMSE and MBI in two groups were increased(P<0.05). while in the respects of abstract and orientation had nosignificant differences(P>0.05). Compared with control group, the Cognitive Assessment Scale scores of M-o CA(23.47±1.53),MMSE(22.50±1.53) and MBI(80.17±4.04) were significantly raisen(P<0.05),but there were no statistically significant difference in abstract and orientation(P>0.05).Conclusion Compared with merely rehabilitation training,rehabilitation training combined with r TMS has a better effect on patients to improve the cognitive impairment and ADL.Therefore these therapy is worth application in clinic.