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浙江大学学报（医学版）
浙江大学学报（医学版）  2021, Vol. 50 Issue (3): 383-389    DOI: 10.3724/zdxbyxb-2021-0184
综述     
重复经颅磁刺激治疗阿尔茨海默病患者的疗效影响因素
王锦涛(),黄蕾,魏丽丽,陈炜()
浙江大学医学院附属邵逸夫医院精神卫生科，浙江 杭州 310016
Factors affecting the efficacy of repetitive transcranial magnetic stimulation for patients with Alzheimer’s disease
WANG Jintao(),HUANG Lei,WEI Lili,CHEN Wei()
Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
 全文: PDF(2045 KB)   HTML( 16 )
摘要：

重复经颅磁刺激（rTMS）是一种安全的非侵入性干预技术，在改善阿尔茨海默病（AD）患者的认知功能上取得了一定的效果，不同rTMS治疗方案之间的疗效差异可能与其刺激频率、模式、部位、维持时间、强度、聚焦能力等因素有关。研究表明，高频rTMS的疗效优于低频；间接θ爆发刺激与常规rTMS疗效相当，但每次治疗时间短，患者依从性增加；刺激AD患者受损脑区或关联网络可增加疗效；短期强化治疗与长期维持治疗结合可维持疗效；结合认知损害程度动态调整刺激强度可增加疗效；利用磁共振功能连接方法等技术可解决rTMS的聚焦能力。本综述分析了上述影响因素，为今后rTMS治疗AD的临床方案设计提供思路。
关键词： 阿尔茨海默病;  重复经颅磁刺激;  认知;  治疗;  影响因素;  综述    
Abstract:

Repetitive transcranial magnetic stimulation (rTMS) is a safe and non-invasive technique. In recent years, many studies have demonstrated that rTMS can improve cognitive function in Alzheimer’s disease (AD) patients and has potential as a therapeutic method for AD. However, the efficacy varies greatly with different rTMS treatment regimens, which is related to the frequency, type, location, duration, intensity and focusing power of stimulation. Recent studies have shown that high-frequency stimulation is superior to low-frequency stimulation; efficacy of intermittent theta burst stimulation (iTBS) is similar to that of conventional rTMS, but iTBS treatment session is shorter and might be more acceptable for AD patients; rTMS stimulation sites targeting AD-damaged brain regions or associated networks would be more effective; short-term intensive treatment combined with long-term maintenance treatment can gain long-term efficacy; dynamic adjustment of stimulus intensity combined with the degree of cognitive impairment can enhance the efficacy; functional connection based on functional magnetic resonance imaging may improve the focusing power of rTMS. In this article, we review the factors related to the efficacy of rTMS, to provide reference for feasible rTMS therapeutic regimens of AD.
Key words: Alzheimer’s disease    Repetitive transcranial magnetic stimulation    Cognition    Therapy    Influence factor    Review
收稿日期: 2021-02-25 出版日期: 2021-08-16
CLC:  R749.1  
基金资助: 国家重点研发计划（2017YFC1310502）；国家自然科学基金（2020C03021）；浙江省重点研发计划（2020C03021）
通讯作者: 陈炜     E-mail: wangjt@zju.edu.cn;srrcw@zju.edu.cn
作者简介: 王锦涛，硕士研究生，主要从事阿尔茨海默病患者的脑功能研究；E-mail：wangjt@zju.edu.cn；https：//orcid.org/0000-0002-4649-7492
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引用本文:

王锦涛,黄蕾,魏丽丽,陈炜. 重复经颅磁刺激治疗阿尔茨海默病患者的疗效影响因素[J]. 浙江大学学报（医学版）, 2021, 50(3): 383-389.

WANG Jintao,HUANG Lei,WEI Lili,CHEN Wei. Factors affecting the efficacy of repetitive transcranial magnetic stimulation for patients with Alzheimer’s disease. J Zhejiang Univ (Med Sci), 2021, 50(3): 383-389.

链接本文:

http://www.zjujournals.com/med/CN/10.3724/zdxbyxb-2021-0184    或    http://www.zjujournals.com/med/CN/Y2021/V50/I3/383

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