基于游戏的脑电神经反馈训练对认知功能改善作用的研究

doi:10.16150/j.1671-2870.2022.01.009

摘要/Abstract

摘要：

目的： 采用基于游戏的脑电神经反馈系统训练认知障碍患者,观察其认知功能的改善状况。目的： 纳入以记忆力下降为主的认知障碍患者52例,先对其进行简易精神状态检查量表（Mini-Mental State Examination, MMSE）、蒙特利尔认知评估量表（Montreal Cognitive Assessment, MoCA）、阿尔茨海默病评定量表-认知量表（Alzheimer′s Disease Assessment Scale-Cognitive section, ADAS-cog）评估。5 d后,对其进行连续10 d的脑电神经反馈“意念力蚂蚁”游戏训练,每天训练30 min。在训练前、训练第10天采集患者的脑电图,训练完成后,再次评估患者的MMSE、MoCA、ADAS-cog评分。结果： 经过训练,患者的MMSE、MoCA、ADAS-cog量表总分提高,训练前得分分别为（23.10±2.82）分、（18.63±4.10）分、（14.76±5.30）分,训练后分别为（26.06±2.95）分、（21.88±3.94）分、（12.15±5.15）分。患者的认知功能总体改善,其中记忆力改善最为明显,训练前MMSE、MoCA、ADAS-cog量表记忆力部分得分分别为（1.55±0.77）分、（1.33±1.28）分、（4.35±1.11）分,训练结束后的MMSE、MoCA、ADAS-cog量表记忆力部分得分分别为（2.16±0.80）分、（2.29±1.34）分、（3.93±1.30）分,训练前、后差异有统计学意义（P<0.001）,同时对患者的脑电复杂度进行计算分析,发现其脑电复杂度提高,以左侧前额叶改善为主。结论： 基于游戏的脑电神经反馈系统训练可显著提高认知障碍患者的认知功能,并能提高其左侧前额叶的脑电复杂度。

关键词: 脑电神经反馈, 记忆力下降, 认知障碍

Abstract:

Objective: To observe the effect of game-based EEG neurofeedback system on improvement of cognitive function in the patients with cognitive impairment. Methods: Fifty-two patients with cognitive impairment, mainly memory decline, were included, and the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA) and Alzheimer′s Disease Assessment Scale-Cognitive section(ADAS-cog) were conducted in the patients to evaluate cognitive impairment. Five days later, each patient was given 30-min EEG neural feedback training, once a day for 10 consecutive days. The EEG was detected before and after training, and MMSE, MoCA and ADAS-cog scores were also evaluated after training. Results: The scores of MMSE, MoCA and ADAS-cog scales after training were all higher(26.06±2.95, 21.88±3.94, 12.15±5.15) than those before training (23.10±2.82, 18.63±4.10, 14.76±5.30) (P<0.05). Before training, the scores of memory on MMSE, MoCA and ADAS-cog scales were 1.55±0.77, 1.33±1.28, 4.35±1.11, respectively, while the above scores increased to 2.16±0.80, 2.29±1.34, 3.93±1.30(P<0.001) after training. The EEG after training showed that the complexity of EEG was improved than that before training, mainly in the left frontal lobe. Conclusions: The game-based EEG neurofeedback system training can significantly improve cognitive function and EEG complexity in the left prefrontal lobe.

Key words: EEG neurofeedback, Memory decline, Cognitive impairment

中图分类号:

R541.7

马少辰, 郭昕, 王铭维, 王惠君, 余启军, 苏文月, 王华龙, 马芹颖. 基于游戏的脑电神经反馈训练对认知功能改善作用的研究[J]. 诊断学理论与实践, 2022, 21(01): 41-45.

MA Shaochen, GUO Xin, WANG Mingwei, WANG Huijun, YU Qijun, SU Wenyue, WANG Hualong, MA Qinying. Effect of game-based EEG neurofeedback training on improvement of cognitive function[J]. Journal of Diagnostics Concepts & Practice, 2022, 21(01): 41-45.

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参考文献 21

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项目	认知障碍患者（n=49）
项目	平均数	中位数	最小值	最大值
年龄（岁）	68.53（6.76）	71.00（9.00）	51	80
身高（mm）	164.31（8.86）	165.00（14.00）	140	180
体重（kg）	68.74（11.00）	70.00（15.00）	47	100
受教育年限（年）	8.10（3.28）	9.00（4.00）	2	17

量表	认知领域	认知功能障碍患者（n=49）
量表	认知领域	训练前（$\bar{x}\pm s$）	训练后（$\bar{x}\pm s$）	t值	P值
MMSE	定向力	8.69±1.28	9.43±1.25	-4.335	<0.001
	即刻回忆	2.90±0.31	2.94±0.24	-1.000	0.322
	注意力和计算力	2.92±0.98	3.73±1.26	-6.157	<0.001
	回忆	1.55±0.77	2.16±0.80	-5.12	<0.001
	语言	7.04±1.27	7.80±1.08	-5.715	<0.001
	MMSE总分	23.10±2.82	26.06±2.95	-17.163	<0.001
MoCA	视空间与执行功能	3.43±1.02	3.65±1.01	-1.909	0.062
	命名	2.29±0.71	2.49±0.65	-2.478	0.017
	注意	4.24±1.41	5.02±1.22	-5.093	<0.001
	语言	1.43±0.76	1.86±0.74	-3.795	<0.001
	抽象	0.80±0.76	1.02±0.80	-2.529	0.015
	延迟回忆	1.33±1.28	2.29±1.34	-6.221	<0.001
	定向	5.12±1.01	5.55±0.87	-3.464	<0.001
	MoCA总分	18.63±4.10	21.88±3.94	-11.098	<0.001
ADAS-cog	单词回忆	4.35±1.11	3.93±1.30	3.891	<0.001
	命名	0.33±0.47	0.08±0.28	3.946	<0.001
	命令	1.29±0.71	1.37±0.83	-0.753	0.455
	结构性练习	0.53±0.50	0.35±0.52	2.438	0.019
	意向性练习	0.53±0.58	0.12±0.39	5.322	<0.001
	定向	0.94±0.94	0.47±0.868	3.892	<0.001
	单词辨认	2.33±1.675	1.59±1.338	5.183	<0.001
	回忆测验指令	1.12±0.949	1.04±0.87	1.000	0.322
	口语能力	0.63±0.76	0.61±0.70	0.573	0.569
	找词困难	0.51±0.79	0.53±0.77	-0.330	0.743
	语言理解力	0.94±0.78	0.90±0.71	0.531	0.598
	注意力	1.27±0.73	1.06±0.83	1.400	0.168
	ADAS-cog总分	14.76±5.30	12.15±5.15	16.056	<0.001

导联	认知功能障碍患者（n=49）
导联	第1天（$\bar{x}\pm s$）	第10天（$\bar{x}\pm s$）	秩和S	P值
FP1	0.09±0.02	0.13±0.02	-26.50	0.022 6
FP2	0.09±0.02	0.13±0.02	-183.50	0.067 4
F3	0.09±0.02	0.13±0.02	-144.50	0.152 6
F4	0.10±0.02	0.13±0.02	-92.50	0.362 9