不同频率经颅磁刺激联合盐酸普拉克索对帕金森病痴呆患者的影响OA

Objective To investigate the effects of different-frequency transcranial magnetic stimulation(TMS)combined with pramipexole hydrochloride in patients with Parkinson's disease dementia(PDD).Methods A total of 120 patients with PDD treated at Beijing Renhe Hospital from January 2021 to January 2024 were enrolled in this study.All participants were randomly assigned to a control group and an experimental group,with 60 cases in each group.Both groups received basic treatment and were given oral pramipexole hydrochloride.The control group received low-frequency(1 Hz)TMS,with 1 second for each stimulation train and an inter-train interval of 3 seconds;the experimental group received high-frequency(10 Hz)TMS,with each stimulation train for 1 second and an inter-train interval of 11 seconds.The total treatment time for both groups was 20 minutes per session,5 times per week,and the treatment lasted for 8 weeks.The severity of the disease was evaluated before and after treatment using the Unified Parkinson's Disease Rating Scale(UPDRS)score,and the cognitive function was assessed using the Mini-Mental State Ex-amination(MMSE),the Montreal Cognitive Assessment(MoCA),and the Mattis Dementia Rating Scale Version 2(MDRS-2).The levels of C-reactive protein(CRP)was measured via immunodiffusion assay,and interleukin-6(IL-6),norepinephrine(NE),and 5-hydroxytryptamine(5-HT)levels were detected via enzyme-linked immunosorbent assay(ELISA).The clinical efficacy and safety were compared between the two groups.Results Compared with those before treatment,the scores of UPDRS Ⅰ,UPDRS Ⅱ,UP-DRS Ⅲ,and UPDRS Ⅳ in both groups decreased after treatment(P<0.05);compared with the control group,the scores of UPDRS Ⅰ,UPDRS Ⅱ,UPDRS Ⅲ,and UPDRS Ⅳ in the experimental group were lower after treatment(P<0.05).Compared with before treat-ment,the scores of MMSE,MoCA and MDRS-2 in both groups increased after treatment(P<0.05);compared with the control group,the scores of MMSE,MoCA and MDRS-2 in the experimental group were higher after treatment(P<0.05).Compared with before treatment,the expression levels of CRP and IL-6 in both groups decreased(P<0.05),and the expression levels of NE and 5-HT in both groups increased(P<0.05);compared with the control group,the expression levels of CRP and IL-6 in the experimental group decreased(P<0.05),and the expression levels of NE and 5-HT increased(P<0.05).Compared with the control group,the total clinical effective rate of the experimental group was higher(P<0.05).The incidence of adverse reactions was 8.83%in the control group and 6.67%in the experimental group.There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Different frequencies of TMS combined with pramipexole hydrochloride can reduce the severity of PDD patients'conditions,improve cognitive function,reduce inflammatory factor levels and increase neu-rotransmitter levels.However,the clinical efficacy of 10 Hz TMS intervention is better than that of 1 Hz TMS.