Effects of repetitive transcranial magnetic stimulation on cognitive function and amplitude of low frequency fluctuations in patients with cognitive dysfunction caused by COPD
Objective To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive function and amplitude of low frequency fluctuations (ALFF) in patients with chronic obstructive pulmonary disease (COPD). Methods A total of 80 patients with stable COPD who visited the Affiliated Hospital of Hangzhou Normal University from October 2020 to June 2024 were prospectively selected as the research objects. They were divided into the rTMS group and the control group by the random number table method,with 40 cases in each group. The control group was given conventional treatment,and the rTMS group was supplemented with rTMS treatment on the basis of conventional treatment. The Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) were used to evaluate the cognitive function of patients before and 4 weeks after treatment. The expression levels of serum neuron-specific enolase (NSE),S-100 calcium-binding protein beta (S-100β),and growth differentiation factor 11 (GDF-11) in patients were detected by ELISA. The MoCA scores,MMSE scores,and the expression levels of serum NSE,S-100β,and GDF-11 in the two groups before and after treatment were compared. Pearson correlation analysis was used to analyze the correlations between the MMSE scores,MoCA scores and the serum NSE,S-100β,GDF-11 of all patients before treatment. The resting-state functional magnetic resonance imaging data of patients in the rTMS group were collected,and the ALFF and fractional amplitude of low frequency fluctuations (fALFF) images were obtained after preprocessing. The ALFF and fALFF values of patients in the rTMS group before and after treatment were compared. Results After treatment,the MoCA scores and the sub-items of MoCA score assessment (visuospatial and executive function,naming,delayed memory,orientation) in the rTMS group were higher than those in the control group,and the MoCA scores,the sub-items of MoCA score assessment (visuospatial and executive function,naming,attention,delayed memory,orientation),and the MMSE scores in the rTMS group were higher than those before treatment,with statistically significant differences (all P<0.05). After treatment,the serum NSE and S-100β levels in the rTMS group were lower than those in the control group and before treatment,and the GDF-11 level was higher than those in the control group and before treatment,with statistically significant differences (all P<0.05). Before treatment,the MoCA scores and MMSE scores of all patients were negatively correlated with the serum NSE and S-100β levels,and positively correlated with the serum GDF-11 level (all P<0.05). After treatment,the ALFF values of the right fusiform gyrus,left middle frontal gyrus,left superior frontal gyrus,and right superior frontal gyrus in the rTMS group were higher than those before treatment,and the fALFF values of the left paracentral lobule and left precuneus were higher than those before treatment,with statistically significant differences (all P<0.05). Conclusion rTMS treatment significantly improves the cognitive dysfunction of COPD patients,and its mechanism may be related to the regulation of spontaneous neuronal activity in specific brain regions by rTMS.
Chronic obstructive pulmonary diseaseCognitive functionTranscranial magnetic stimulationResting-state functional magnetic resonance imaging
万方数据
维普
