CN116870366A - Repeated transcranial magnetic stimulation individuation data processing method for Alzheimer disease - Google Patents
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Abstract
The invention discloses a repeated transcranial magnetic stimulation personalized data processing method aiming at Alzheimer disease, which comprises the following steps of S11, establishing a personalized stimulation model, combining an electroencephalogram feedback mechanism with a repeated transcranial magnetic stimulation process, determining preliminary parameters of the personalized stimulation model, S12, grouping a plurality of patients, respectively carrying out repeated transcranial magnetic stimulation according to the personalized stimulation model to obtain a stimulation result, S13, carrying out electroencephalogram and psychological measurement evaluation according to the stimulation result, and obtaining final parameters of the personalized stimulation model again according to the evaluation result; in the step S11, the method for determining the preliminary parameters of the personalized stimulation model includes the following steps that S111, based on the frequency of the brain wave neural activity alpha wave band, the personalized stimulation frequency is determined; s112, repeating transcranial magnetic stimulation, and determining the individual stimulation intensity. The invention has the advantage of further improving the effect of rTMS treatment.
Description
Technical Field
The invention belongs to the field of Alzheimer's disease data processing, and particularly relates to a repeated transcranial magnetic stimulation individuation data processing method aiming at Alzheimer's disease.
Background
With the development of non-invasive brain stimulation techniques, repeated transcranial magnetic stimulation (repeated transcranial magnetic stimulation, rTMS) can improve cognitive function and performance of alzheimer's disease (Alzheimer disease, AD). rTMS can modulate the activity of specific target brain regions and their connective networks, can cause cortical excitability changes, increase brain plasticity, produce LTP enhancement, promote recombination of damaged neural networks, and have been applied in recent years to clinical treatment of AD, primarily by rTMS treatment lasting weeks or months, to improve cognitive function in patients. Combining the meta-analysis of the current study, it was found that continuous 2 weeks of rTMS treatment improved cognitive function, which effect was maintained for at least 8 weeks, was a promising treatment for AD.
With respect to achieving improved efficacy through modulation of rTMS stimulation sequence parameters, most current studies focus on selection of stimulation targets, typically selecting left or right dorsal lateral prefrontal cortex (dorsolateral prefrontal cortex, DLPFC), as well as studies using temporal parietal lobes or other multiple targets. Although the stimulation targets were chosen differently, rTMS treatment improved cognitive function in AD, with only a difference in the characteristic symptoms of improving cognitive function. In terms of stimulation frequency, it is generally divided into high frequency and low frequency: high frequency isThe frequency used in most clinics is 10Hz. The selection of a fixed frequency for treatment of all patients in clinical therapy, but the different brain cortex activities of different subjects, is considered to be a major factor affecting the efficacy. In terms of stimulation intensity, the minimum intensity of the dominant muscle contraction caused by TMS acting on the motor cortex in the resting state, i.e. resting cortical motor threshold (rest motor threshold, rMT), is usually treated clinically with some intensity of 80% -120% rmt to the patient. Has study on normal testThe cognitive performance of N-back can be improved by 50%, 75% and 100% of rMT stimulation, and the reaction time is shortened, wherein rMT is the most obvious at 75%. But another was 60%, 80%,100%,120% stimulation with rMT, and the excitability of the cerebral cortex was found to have a dependent effect on the intensity of stimulation 4. Overall, rTMS can improve cognitive function of AD, which holds promise for current dilemma treatment of AD, but it is not clear within the industry how to further increase the effect of rTMS.
Disclosure of Invention
The invention aims to provide a repeated transcranial magnetic stimulation individualization data processing method aiming at Alzheimer disease. The invention has the advantage of further improving the effect of rTMS treatment.
The technical scheme of the invention is as follows: a method for processing repeated transcranial magnetic stimulation personalized data for Alzheimer's disease, comprising the steps of,
s11, combining an electroencephalogram feedback mechanism with a repeated transcranial magnetic stimulation process to establish an individuation stimulation model,
s12, grouping a plurality of patients, respectively carrying out repeated transcranial magnetic stimulation according to an individuation stimulation model to obtain a stimulation result,
and S13, performing electroencephalogram and psychological measurement evaluation according to the stimulation result, and obtaining final parameters of the personalized stimulation model according to the evaluation result.
2. The method for repeated transcranial magnetic stimulation personalized data processing for alzheimer's disease according to claim 1, wherein: in the step S11, the method for determining the preliminary parameters of the personalized stimulation model by combining the electroencephalogram feedback mechanism with the repeated transcranial magnetic stimulation process comprises the following steps,
s111, determining an individual stimulation frequency based on the frequency of an alpha wave band of brain wave neural activity of an individual;
s112, repeating transcranial magnetic stimulation by adopting the established individuation stimulation frequency, and determining individuation stimulation intensity according to an electroencephalogram feedback mechanism.
In the above-mentioned method for processing the personalized data of repeated transcranial magnetic stimulation for alzheimer' S disease, in the step S11, the method for determining the preliminary parameters of the personalized stimulation model by combining the electroencephalogram feedback mechanism with the repeated transcranial magnetic stimulation process includes the following steps,
s111, determining an individual stimulation frequency based on the frequency of an alpha wave band of brain wave neural activity of an individual;
s112, repeating transcranial magnetic stimulation by adopting the established individuation stimulation frequency, and determining individuation stimulation intensity according to an electroencephalogram feedback mechanism.
In the aforementioned method for processing the personalized data of repeated transcranial magnetic stimulation for Alzheimer' S disease, in the step S111, the method for determining the personalized stimulation frequency based on the frequency of the brain wave neural activity alpha wave band comprises the following steps,
s1111, analyzing the brain electricity when the base line is formed, and obtaining the peak frequency of the alpha wave band of each electrode;
s1112, taking the average value of peak frequencies of alpha wave bands of a plurality of electrodes near the stimulation target P3 as the individuation stimulation frequency.
In the aforementioned method for processing repeated transcranial magnetic stimulation personalized data for alzheimer' S disease, in step S1112, the plurality of electrodes near the stimulation target P3 are respectively seven electrodes of T3, C3, cz, T5, P3, pz, O1.
In the above-mentioned method for processing the personalized data of repeated transcranial magnetic stimulation for Alzheimer' S disease, in the step S112, the repeated transcranial magnetic stimulation is performed with the established personalized stimulation frequency, and the method for determining the personalized stimulation intensity according to the electroencephalogram feedback mechanism comprises the following steps,
s1121, acquiring brain electricity of a first preset time length, and obtaining alpha wave band amplitude before stimulation;
s1122, repeating transcranial magnetic stimulation with the established individual stimulation frequency at stimulation intensities of 80%,100% and 120%, respectively, for a second preset period of time;
s1123, observing the amplitudes of the alpha wave band frequencies of the dry prognosis electroencephalogram respectively, and selecting the stimulation intensity when the maximum amplitude is generated as the individual stimulation intensity according to an electroencephalogram feedback mechanism.
In the aforementioned method for processing the personalized data of repeated transcranial magnetic stimulation for Alzheimer' S disease, in the step S12, the method for grouping patients to perform repeated transcranial magnetic stimulation comprises the following steps,
s121, dividing a plurality of patients into an individualized stimulation frequency group, an individualized stimulation intensity group, an individualized stimulation frequency intensity group and a control group;
s122, each group adopts the P3 point of the electroencephalogram 10-20 as a stimulation target point to carry out stimulation treatment;
s123, respectively acquiring electroencephalogram data of 5 minutes at the 2 nd week and the 8 th week, and comparing the changes of the electroencephalogram before and after treatment.
In the aforementioned method for processing repeated transcranial magnetic stimulation personalized data for alzheimer' S disease, in step S122, the stimulation treatment is performed for a total of 40 cycles of stimulation treatment, each cycle of stimulation for 2 seconds, and the cycle interval for 28 seconds is performed for a total of 2 weeks and 5 times per week.
In the aforementioned method for processing repeated transcranial magnetic stimulation personalized data for alzheimer' S disease, in step S121,
the personalized stimulation frequency of the personalized stimulation frequency group is determined by personalized stimulation model parameters, and the stimulation intensity is adjusted to 100% rMT;
the stimulation frequency of the personalized intensity group is adjusted to 10Hz, and the personalized stimulation intensity is determined by the parameters of the personalized stimulation model;
the stimulation frequencies of the individualized stimulation frequency intensity sets are determined by individualized stimulation model parameters, and the stimulation intensities are determined by individualized stimulation model parameters;
the stimulation frequency of the control group was adjusted to 10Hz and the stimulation intensity to 100% rmt.
In the aforementioned method for processing repeated transcranial magnetic stimulation personalized data for Alzheimer' S disease, in the step S13, a method for evaluating electroencephalogram and psychological measurements is performed, comprising the steps of,
s131, evaluating simple intelligence state examination, neuropsychiatric scale, philadelphia language learning test and a career burden questionnaire on a basic line and the 2 nd week, the 4 th week, the 8 th week and the 12 th week of each group of patients respectively, and observing the change of scores of all time points before and after the treatment of each group of patients;
s132, evaluating the continuous change condition of the scales before and after each treatment by adopting repeated measurement variance analysis, performing post-hoc comparison by adopting a Bonferroni multiple comparison method, selecting the optimal treatment group with the highest value improvement of the scales after repeated transcranial magnetic stimulation treatment, and taking the parameters used in the optimal treatment group as the final parameters of the personalized stimulation model;
s133, carrying out consistency detection among different assessment personnel, namely respectively carrying out score statistics on the scale results of 10 testers by a plurality of assessment personnel, wherein the score statistics is that Kendall coefficient is more than or equal to 0.85;
s134, consistency test is carried out every half year.
In the aforementioned method for processing repeated transcranial magnetic stimulation personalized data for alzheimer' S disease, in step S131, a simple mental state check and a philadelphia language learning test are performed as a question test for evaluating a cognitive function of a patient, answers of each question are recorded and scores are counted, a neuropsychiatric scale and a caretaker burden questionnaire are performed as a question of the caretaker of the patient, and scores of scales of each group of patients at baseline, week 2, week 4, week 8, week 12 are recorded according to the answer scores.
Compared with the prior art, the invention provides the Alzheimer's disease repeated transcranial magnetic stimulation personalized data processing method based on brain electrical feedback, establishes a personalized stimulation model, can provide reference for selecting proper stimulation parameters for patients, and has the advantage of further improving the rTMS treatment effect.
Drawings
Fig. 1 is a flow chart of the present invention.
FIG. 2 is a partial comparison of individualized stimulation frequencies determined by the present invention using an electroencephalographic feedback mechanism with conventional stimulation frequencies.
FIG. 3 is a partial comparative schematic of the personalized stimulation intensity determined by the present invention using an electroencephalographic feedback mechanism with conventional stimulation intensity.
FIG. 4 is a graph showing the comparison of MMSE and PVLT improvement rates before and after treatment by repeated transcranial magnetic stimulation treatment of patients with mild Alzheimer's disease in accordance with the present invention.
FIG. 5 is an international 10-20 system electrode position diagram.
Detailed Description
The invention is further illustrated by the following figures and examples, which are not intended to be limiting.
Examples. A method for processing repeated transcranial magnetic stimulation personalized data for Alzheimer's disease comprises the following steps,
s11, combining an electroencephalogram feedback mechanism with a repeated transcranial magnetic stimulation process to establish an individuation stimulation model,
s12, grouping 120 cases of mild AD patients, respectively performing repeated transcranial magnetic stimulation according to an individuation stimulation model to obtain a stimulation result,
and S13, performing electroencephalogram and psychological measurement evaluation according to the stimulation result, and obtaining final parameters of the personalized stimulation model according to the evaluation result.
In the step S11, the method for combining the electroencephalogram feedback mechanism with the repeated transcranial magnetic stimulation process to establish the personalized stimulation model comprises the following steps,
s111, determining an individual stimulation frequency based on the frequency of an alpha wave band of brain wave neural activity of an individual;
s112, repeating transcranial magnetic stimulation by adopting the established individuation stimulation frequency, and determining individuation stimulation intensity according to an electroencephalogram feedback mechanism.
In the step S111, the method for determining the personalized stimulation frequency based on the frequency of the alpha wave band of the brain wave neural activity of the individual comprises the following steps,
s1111, analyzing brain electricity when an individual basic line is performed to obtain peak frequency of alpha wave bands of each electrode;
s1112, taking the average value of the peak frequencies of the alpha wave bands of a plurality of electrodes near a stimulation target P3 (the rTMS adopting the left top leaf as the stimulation target can improve the memory function of normal people, and the result of the rTMS study adopting the functional magnetic resonance to locate the left top leaf in the early-stage experiment also shows that the cognitive function of AD patients is improved), wherein the peak frequencies are taken as the individuation stimulation frequencies, the individuation stimulation frequencies of each person are different, and the obtained individuation stimulation frequencies are distributed between 7 Hz and 11Hz, which is different from the fixed use of 10Hz by a conventional treatment method.
In the step S1112, the plurality of electrodes near the stimulation target P3 are respectively seven electrodes of T3, C3, cz, T5, P3, pz, O1.
In the step S112, the transcranial magnetic stimulation is repeated by adopting the established personalized stimulation frequency, and the method for determining the personalized stimulation intensity according to the electroencephalogram feedback mechanism comprises the following steps,
s1121, acquiring brain electricity of a first preset time period (namely acquiring brain electricity of 2 minutes), and acquiring alpha wave band amplitude before stimulation;
s1122, repeating transcranial magnetic stimulation with the established individual stimulation frequency at stimulation intensities of 80%,100% and 120% respectively, wherein each stimulation is performed for a second preset time period (namely, 2 minutes of electroencephalogram acquisition);
s1123, observing the amplitudes of the alpha wave band frequencies of the dry prognosis electroencephalogram respectively, and selecting the stimulation intensity when the maximum amplitude is generated as the individual stimulation intensity according to an electroencephalogram feedback mechanism. As shown in fig. 3, the individual intensity of each individual is different, possibly 80% rmt, or 100% rmt and 120% rmt, as determined by the maximum amplitude.
In the step S12, the method for repeated transcranial magnetic stimulation of patient groups comprises the steps of,
s121, dividing the patients into an individualized stimulation frequency group, an individualized stimulation intensity group, an individualized stimulation frequency intensity group and a control group, wherein 30 cases are respectively arranged in each group;
s122, each group adopts the P3 point of the electroencephalogram 10-20 as a stimulation target point to carry out stimulation treatment;
s123, respectively acquiring electroencephalogram data of 5 minutes at the 2 nd week and the 8 th week, and comparing the electroencephalogram data with the electroencephalogram data in groups to obtain the change condition of the electroencephalogram before and after the individual treatment by the comparison in the groups, and obtaining the difference of the electroencephalogram change of different treatment groups by the comparison between the groups.
In step S122, the stimulation treatment is performed for a total of 40 cycles, each cycle is stimulated for 2 seconds, and the cycle interval is 28 seconds, and the stimulation treatment is performed for 2 weeks and 5 times per week.
In the step S121, the personalized stimulation frequency of the personalized stimulation frequency group is obtained by a personalized stimulation model, and the stimulation intensity is adjusted to 100% rmt, that is, the combination of the parameters used is the personalized stimulation frequency+100% rmt; the stimulation frequency of the personalized intensity group is adjusted to 10Hz, and the personalized stimulation intensity is obtained by the parameters of the personalized stimulation model, namely, the combination of the parameters is 10 Hz+the personalized intensity; the stimulation frequency of the personalized stimulation frequency intensity group is determined by personalized stimulation model parameters, and the stimulation intensity is determined by personalized stimulation model parameters, namely, the used parameters are combined into personalized stimulation frequency and personalized intensity; the stimulation frequency of the control group was adjusted to 10Hz and the stimulation intensity to 100% rmt, i.e. the combination of parameters used was 10hz+100% rmt.
In the step S13, the method for evaluating electroencephalogram and psychological measurement includes the following steps,
s131, evaluating a simple mental state examination (Mini-mental State Examination, MMSE), a neuropsychiatric scale (Neuropsychiatric Inventory, NPI), a Philadelphia language learning test (Philadelphia Verbal Learning Test, PVLT) and a caretaker burden questionnaire (Caregiver burden inventory, CBI) on a basal line and at weeks 2, 4, 8 and 12 respectively to examine the change of scores at various time points before and after the treatment of each group of patients;
s132, evaluating the continuous change condition of the scales before and after treatment of each group by adopting repeated measurement variance analysis, carrying out post-hoc comparison by adopting a Bonferroni multiple comparison method, selecting the optimal treatment group with the highest scale value improvement after repeated transcranial magnetic stimulation treatment, wherein if a final result shows that the personalized frequency component value is the optimal treatment group, the final parameter combination of the personalized stimulation model is personalized stimulation frequency +100%rMT at the moment, and the personalized stimulation model is adopted when the final parameter combination is really put into each hospital for treating patients;
s133, carrying out consistency detection among different assessment personnel, namely respectively carrying out score statistics on the scale results of 10 testers by a plurality of assessment personnel, wherein the score statistics is that Kendall coefficient is more than or equal to 0.85; the consistency is good by representing different raters, and the raters are retrained until passed if not passed.
S134, consistency test is carried out every half year, consistency of assessment staff is guaranteed, otherwise, training is needed again until passing.
In step S131, the simple mental state examination and philadelphia language learning test are carried out as a question test in which an evaluator carries out a cognitive function for a patient one by one, answers of each question are recorded and scores are counted, a neuropsychiatric scale and a questionnaire burden of a career are carried out as questions for the evaluator to the caretaker of the patient, and scores of each scale of each group of patients at baseline, week 2, week 4, week 8 and week 12 are recorded according to the answer statistical scores.
As shown in FIG. 4, the method of the embodiment of the invention is used for carrying out rTMS treatment on mild Alzheimer disease patients, the individuation frequency is between 7 and 11Hz, compared with patients in a conventional method, after 10 stimulation interventions, the cognitive scores of MMSE and PVLT are obviously improved, and the individuation rTMS group improvement rate is superior to that of the conventional rTMS group.
Claims (10)
1. A method for processing repeated transcranial magnetic stimulation individuation data aiming at Alzheimer disease, which is characterized in that: comprises the steps of,
s11, combining an electroencephalogram feedback mechanism with a repeated transcranial magnetic stimulation process to establish an individuation stimulation model,
s12, grouping a plurality of patients, respectively carrying out repeated transcranial magnetic stimulation according to an individuation stimulation model to obtain a stimulation result,
and S13, performing electroencephalogram and psychological measurement evaluation according to the stimulation result, and obtaining final parameters of the personalized stimulation model according to the evaluation result.
2. The method for repeated transcranial magnetic stimulation personalized data processing for alzheimer's disease according to claim 1, wherein: in the step S11, the method for determining the preliminary parameters of the personalized stimulation model by combining the electroencephalogram feedback mechanism with the repeated transcranial magnetic stimulation process comprises the following steps,
s111, determining an individual stimulation frequency based on the frequency of an alpha wave band of brain wave neural activity of an individual;
s112, repeating transcranial magnetic stimulation by adopting the established individuation stimulation frequency, and determining individuation stimulation intensity according to an electroencephalogram feedback mechanism.
3. The method for repeated transcranial magnetic stimulation personalized data processing for alzheimer's disease according to claim 2, wherein: in the step S111, the method for determining the personalized stimulation frequency based on the frequency of the brain wave neural activity alpha wave band comprises the following steps,
s1111, analyzing the brain electricity when the base line is formed, and obtaining the peak frequency of the alpha wave band of each electrode;
s1112, taking the average value of peak frequencies of alpha wave bands of a plurality of electrodes near the stimulation target P3 as the individuation stimulation frequency.
4. A method of repeated transcranial magnetic stimulation personalized data processing for alzheimer's disease according to claim 3, wherein: in the step S1112, the plurality of electrodes near the stimulation target P3 are respectively seven electrodes of T3, C3, cz, T5, P3, pz, O1.
5. The method for repeated transcranial magnetic stimulation personalized data processing for alzheimer's disease according to claim 2, wherein: in the step S112, the transcranial magnetic stimulation is repeated by adopting the established personalized stimulation frequency, and the method for determining the personalized stimulation intensity according to the electroencephalogram feedback mechanism comprises the following steps,
s1121, acquiring brain electricity of a first preset time length, and obtaining alpha wave band amplitude before stimulation;
s1122, repeating transcranial magnetic stimulation with the established individual stimulation frequency at stimulation intensities of 80%,100% and 120%, respectively, for a second preset period of time;
s1123, observing the amplitudes of the alpha wave band frequencies of the dry prognosis electroencephalogram respectively, and selecting the stimulation intensity when the maximum amplitude is generated as the individual stimulation intensity according to an electroencephalogram feedback mechanism.
6. The method for repeated transcranial magnetic stimulation personalized data processing for alzheimer's disease according to claim 1, wherein: in the step S12, the method for repeated transcranial magnetic stimulation of patient groups comprises the steps of,
s121, dividing a plurality of patients into an individualized stimulation frequency group, an individualized stimulation intensity group, an individualized stimulation frequency intensity group and a control group;
s122, each group adopts the P3 point of the electroencephalogram 10-20 as a stimulation target point to carry out stimulation treatment;
s123, respectively acquiring electroencephalogram data of 5 minutes at the 2 nd week and the 8 th week, and comparing the changes of the electroencephalogram before and after treatment.
7. The method for repeated transcranial magnetic stimulation personalized data processing for alzheimer's disease according to claim 6, wherein: in step S122, the stimulation treatment is performed for a total of 40 cycles, each cycle is stimulated for 2 seconds, and the cycle interval is 28 seconds, and the stimulation treatment is performed for 2 weeks and 5 times per week.
8. The method for repeated transcranial magnetic stimulation personalized data processing for alzheimer's disease according to claim 6, wherein: in the step S121 of the above-mentioned process,
the personalized stimulation frequency of the personalized stimulation frequency group is determined by personalized stimulation model parameters, and the stimulation intensity is adjusted to 100% rMT;
the stimulation frequency of the personalized intensity group is adjusted to 10Hz, and the personalized stimulation intensity is determined by the parameters of the personalized stimulation model;
the stimulation frequencies of the individualized stimulation frequency intensity sets are determined by individualized stimulation model parameters, and the stimulation intensities are determined by individualized stimulation model parameters;
the stimulation frequency of the control group was adjusted to 10Hz and the stimulation intensity to 100% rmt.
9. The method for repeated transcranial magnetic stimulation personalized data processing for alzheimer's disease according to claim 1, wherein: in the step S13, the method for evaluating electroencephalogram and psychological measurement includes the following steps,
s131, evaluating simple intelligence state examination, neuropsychiatric scale, philadelphia language learning test and a career burden questionnaire on a basic line and the 2 nd week, the 4 th week, the 8 th week and the 12 th week of each group of patients respectively, and observing the change of scores of all time points before and after the treatment of each group of patients;
s132, evaluating the continuous change condition of the scales before and after each treatment by adopting repeated measurement variance analysis, performing post-hoc comparison by adopting a Bonferroni multiple comparison method, selecting the optimal treatment group with the highest value improvement of the scales after repeated transcranial magnetic stimulation treatment, and taking the parameters used in the optimal treatment group as the final parameters of the personalized stimulation model;
s133, carrying out consistency detection among different assessment personnel, namely respectively carrying out score statistics on the scale results of 10 testers by a plurality of assessment personnel, wherein the score statistics is that Kendall coefficient is more than or equal to 0.85;
s134, consistency test is carried out every half year.
10. The method for repeated transcranial magnetic stimulation personalized data processing for alzheimer's disease according to claim 9, wherein: in step S131, the simple mental state examination and philadelphia language learning test are carried out as a question test in which an evaluator carries out a cognitive function for a patient one by one, answers of each question are recorded and scores are counted, a neuropsychiatric scale and a questionnaire burden of a career are carried out as questions for the evaluator to the caretaker of the patient, and scores of each scale of each group of patients at baseline, week 2, week 4, week 8 and week 12 are recorded according to the answer statistical scores.
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