重复经颅磁刺激联合认知训练对阿尔茨海默病患者血清炎症因子及T 淋巴细胞亚群的影响

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Abstract Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) combined with computerized cognitive training(CCT)on serum inflammatory factors and T lymphocyte subsets in Alzheimer's disease(AD).Methods A total of 76 patients with mild AD who met the inclusion criteria and treated in the Second Affiliated Hospital of Zhengzhou University from October 2020 to May 2022 were selected as the study objects.They were divided into treatment group and control group by random number method,with 38 patients in each group.Patients in the treatment group were treated with rTMS combined with CCT,and patients in the control group were treated with transcranial magnetic pseudo-stimulation combined with CCT.After treatment,the cognitive functions of the two groups were compared by the mini-mental state examination(MMSE)and the Alzheimer's disease assessment scale-cognition(ADAS-COG).The levels of interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),interferon-γ (IFN-γ),killer T cells (TC),helper T cells (TH)and regulatory T cells (Tregs)before and after treatment were compared between the two groups.Results The levels of IL-6 and TNF-α in the treatment group were lower than those in the control group,and the differences were statistically significant(P＜0.05).TH and Tregs levels in the treatment group were higher than those in the control group after treatment,and the differences were statistically significant(P＜0.05).After treatment,the ADAS-COG score of the treatment group was lower than that of the control group,and the MMSE score was higher than that of the control group,with statistical significances (P＜0.05).There were no significant differences in IFN-γ and TC levels between the two groups after treatment (P＞0.05).After treatment,the levels of IL-6 and TNF-α in the treatment group were lower than those before treatment,and the level of IL-6 in the control group was lower than those before treatment,the differences were statistically significant (P＜0.05).After treatment,TH and Tregs levels in the treatment group were higher than those before treatment,and the differences were statistically significant(P＜0.05).After treatment,the ADAS-COG scores of both groups were lower than those before treatment,and the MMSE scores were higher than those before treatment,with statistical significances(P＜0.05).Conclusion rTMS combined with CCT can reduce serum IL-6,TNF-α,increase serum TH,Tregs levels and improve cognitive function in AD patients.

Key words： Repetitive transcranial magnetic stimulation Cognitive training Alzheimer's disease Cognitive function Alzheimer's disease assessment scale-cognition Inflammatory factors T lymphocyte

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