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小脑顶核电刺激治疗非痴呆型血管性认知障碍的多体素氢质子磁共振波谱分析

Analysis in multivoxel 1H-magnetic resonance spectroscopy for vascular cognitive impairment none dementia by cerebellar fastigial nucleus stimulation

    摘要
  • 摘要:
      目的  使用多体素氢质子磁共振波谱（1H-MRS）观察小脑顶核电刺激（FNS）治疗非痴呆型血管性认知障碍（VCIND）后脑代谢物的改变。
      方法  将51例VCIND患者随机分为观察组（25例）和对照组（26例）。2组均予以常规药物治疗，且观察组给予FNS治疗。采用简易精神状态量表（MMSE）及蒙特利尔认知评估量表（MoCA）评定2组VCIND患者治疗前后认知功能，并使用1H-MRS检查双侧额叶、海马、后扣带回、丘脑及角回代谢物。
      结果  观察组FNS治疗后MMSE及MoCA评分较治疗前和对照组提高，差异有统计学意义（P < 0.05）。观察组治疗后双侧额叶、海马、后扣带回、丘脑及角回的N-乙酰天冬氨酸与肌酸比值较治疗前和对照组升高，差异有统计学意义（P < 0.05）。治疗后，2组均未发生不良反应事件。
      结论  FNS可改善VCIND患者的认知功能，可能成为治疗VCIND的一种新型、安全的非药物性方法。多体素1H-MRS可成为观察FNS治疗VCIND效果的一种有效手段。

     

    Abstract:
      Objective  To observe the changes of brain metabolites in patients with vascular cognitive impairment none dementia (VCIND) after cerebellar fastigial nucleus stimulation (FNS) by multivoxel 1H-magnetic resonance spectroscopy(1H-MRS).
      Methods  A total of 51 cases with VCIND were randomly divided into observation group (n=25) and control group (n=26). Both groups were treated with conventional medicine, and the observation group was further treated with FNS. Before and after treatment, Mini-mental Status Examination(MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess the cognitive function of the two groups, and multivoxel 1H-MRS was used to detect the metabolites in bilateral frontal lobes, hippocampi, thalami, posterior cingulate gyri and angular gyri.
      Results  MMSE and MoCA scores in the observation group after FNS treatment were significantly higher than those before FNS treatment and the control group(P < 0.05). After treatment, the ratio of N-acetylaspartic acid to creatine in bilateral frontal lobe, hippocampus, posterior cingulate gyrus, thalamus and angular gyrus in the observation group was increased compared with that before treatment and the control group (P < 0.05). There were no adverse reactions in both groups after treatment.
      Conclusion  FNS can improve the cognitive function in patients with VCIND, and may be a new and safe method of non-drug treatment for VCIND. Multivoxel 1H-MRS may be a useful tool to observe the effect of FNS in treating VCIND.

     

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