基于事件相关电位探讨太极拳联合经颅直流电刺激对轻度认知障碍患者P300的影响

关键词：轻度认知障碍  太极拳  经颅直流电刺激  事件相关电位  P300

Keywords:mild cognitive impairment  Tai Chi  transcranial direct current stimulation  event-related potential  P300

摘要：

      摘要 目的：利用事件相关电位（event-related potential， ERP）P300探讨为期12周太极拳联合经颅直流电刺激（transcranial direct current stimulation， tDCS）对轻度认知障碍（mild cognitive impairment， MCI）患者认知功能的影响。 方法：将79例MCI患者随机分为4组：太极拳+tDCS组20例，接受太极拳训练联合阳极tDCS刺激；太极拳+伪tDCS组20例，接受太极拳训练联合伪tDCS刺激；健步走+tDCS组19例，接受健步走训练联合tDCS刺激；健步走+伪tDCS组20例，接受健步走训练联合伪tDCS刺激。干预周期为每周3次，每次1h，持续12周。干预前后采用蒙特利尔认知功能评估量表（Montreal cognitive assessment，MoCA）评估整体认知功能，中文版韦氏成人记忆量表评估记忆功能，同时记录ERP-P300波幅和潜伏期的变化。 结果：①12周干预后太极拳+tDCS组MoCA评分显著高于健步走+伪tDCS组（P=0.009）；太极拳+tDCS组记忆商评分显著高于太极拳+伪tDCS组（P=0.010）、健步走+tDCS组（P=0.004）及健步走+伪tDCS组（P=0.008）。②12周干预后太极拳+tDCS组Pz、Cz电极处波幅显著高于健步走+伪tDCS组（P分别为<0.001、0.001），太极拳+tDCS组Fz波幅显著高于健步走+tDCS组（P=0.011）及健步走+伪tDCS组（P=0.002）。③偏相关分析结果显示，MoCA总分变化与Fz电极处波幅变化存在相关性（r=0.261，P=0.034）。 结论：为期12周太极拳联合tDCS的干预可以改善MCI患者认知功能，增加ERP-P300在Pz波幅、Fz波幅、Cz电极处波幅，且整体认知功能的改变可能与Fz电极处波幅的变化有关。

Abstract:

      Abstract Objective： To evaluate the effects of 12 weeks of Tai Chi combined with transcranial direct current stimulation （tDCS） on cognitive functioning in patients with mild cognitive impairment （MCI） using event-related potential （ERP）-P300. Method： Seventy-nine patients with MCI were randomly divided into 4 groups： Tai Chi + tDCS group （n=20） received Tai Chi training combined with anodic tDCS； Tai Chi + sham tDCS group （n=20） received Tai Chi training combined with sham tDCS； walking + tDCS group （n=19） received walking training combined with tDCS； walking + sham tDCS group （n=20） received walking combined with sham tDCS group. The duration of the intervention was 3 times per week， 1 hour/session， for 12 weeks. All participants were assessed at baseline and 12 weeks for global cognitive function， memory， ERP-P300 wave amplitude and latency. Result： After 12 weeks of intervention， the MoCA score of Tai Chi + tDCS group were significantly higher than walking + sham tDCS group （P=0.009）； the MQ score of Tai Chi + tDCS group were significantly higher than Tai Chi + sham tDCS group （P=0.010）， walking + tDCS group （P=0.004） and walking + sham tDCS group （P=0.008）. P300 amplitudes at the Pz amplitude and Cz amplitude of Tai Chi + tDCS group were significantly higher than walking + sham tDCS group （P<0.001，P=0.001）， the Fz amplitude of Tai Chi + tDCS group were significantly higher than walking + tDCS group （P=0.011） and walking + sham tDCS group （P=0.002）. Partial correlation analysis showed that the change of MoCA score was correlated with the change of Fz amplitude （r=0.261， P=0.034）. Conclusion： A 12-week intervention of Tai Chi combined with tDCS can improve the cognitive function and increase Pz amplitude， Fz amplitude， Cz amplitude in MCI patients， and the change of overall cognitive function may be related to the change of Fz amplitude.