认知训练联合重复经颅磁刺激对卒中后认知障碍伴淡漠患者的效果

注册号:

Registration number:

ChiCTR2500102915 

最近更新日期:

Date of Last Refreshed on:

2025-05-21 15:35:31 

注册时间:

Date of Registration:

2025-05-21 00:00:00 

注册号状态:

补注册

Registration Status:

Retrospective registration

注册题目:

认知训练联合重复经颅磁刺激对卒中后认知障碍伴淡漠患者的效果

Public title:

Effectiveness of cognitive training combined with repetitive transcranial magnetic stimulation in patients with post-stroke cognitive impairment with apathy

注册题目简写:

English Acronym:

研究课题的正式科学名称:

认知训练联合重复经颅磁刺激对卒中后认知障碍伴淡漠患者的效果

Scientific title:

Effectiveness of cognitive training combined with repetitive transcranial magnetic stimulation in patients with post-stroke cognitive impairment with apathy

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

谭绍英 

研究负责人:

谭绍英 

Applicant:

Tan Shaoying 

Study leader:

Tan Shaoying 

申请注册联系人电话:

Applicant telephone:

+86 136 1754 7996

研究负责人电话:

Study leader's
telephone:

+86 136 1754 7996

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

314097132@qq.com

研究负责人电子邮件:

Study leader's E-mail:

314097132@qq.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

海南省海口市龙华路31号

研究负责人通讯地址:

海南省海口市龙华路31号

Applicant address:

No.31 Longhua Road, Haikou City, Hainan Province, China

Study leader's address:

No.31 Longhua Road, Haikou City, Hainan Province, China

申请注册联系人邮政编码:

Applicant postcode:

570102

研究负责人邮政编码:

Study leader's postcode:

570102

申请人所在单位:

海南医科大学第一附属医院

Applicant's institution:

The First Affiliated Hospital of Hainan Medical University

研究负责人所在单位:

海南医科大学第一附属医院

Affiliation of the Leader:

The First Affiliated Hospital of Hainan Medical University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2023-KYL-161

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

海南医学院第一附属医院医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee of the First Affiliated Hospital of Hainan Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2023-11-10 00:00:00

伦理委员会联系人:

林萍

Contact Name of the ethic committee:

LIN Ping

伦理委员会联系地址:

海南省海口市龙华路31号

Contact Address of the ethic committee:

No.31 Longhua Road, Haikou City, Hainan Province, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 139 0758 8016

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

海南医科大学第一附属医院

Primary sponsor:

The First Affiliated Hospital of Hainan Medical University

研究实施负责(组长)单位地址:

海南省海口市龙华路31号

Primary sponsor's address:

No.31 Longhua Road, Haikou City, Hainan Province, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

海南省

市(区县):

海口市

Country:

China

Province:

Hainan

City:

Haikou

单位(医院):

海南医科大学第一附属医院

具体地址:

海南省海口市龙华路31号

Institution
hospital:

The First Affiliated Hospital of Hainan Medical University

Address:

No.31 Longhua Road, Haikou City, Hainan Province, China

经费或物资来源:

HNYFYPY202312

Source(s) of funding:

HNYFYPY202312

研究疾病:

卒中  

Target disease:

Sroke

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

探究认知训练联合重复经颅磁刺激对卒中后认知障碍伴淡漠患者认知功能的效果。  

Objectives of Study:

This project intends to investigate the effect of cognitive training combined with repetitive transcranial magnetic stimulation on cognitive function in patients with post-stroke cognitive impairment with apathy.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.卒中前已存在认知障碍者; 2.既往服用多哌奈齐等改善认知功能的药物或接受其他认知康复的患者; 3.有rTMS治疗禁忌症者(心脏植入起搏器、颅脑金属植入物、人工耳蜗等); 4. 合并严重的心、肺、肾等器官疾病无法配合干预者,不识汉字者;存在语言、视功能、听力功能障碍。

Exclusion criteria:

1.Patients with contraindications to rTMS treatment, such as cardiac implantation of pacemakers, cranial metal implants, cochlear implants and so on. 2.Patients with combined severe cardiac, pulmonary, renal and other organ-based diseases; other diseases that cause apathy, such as Parkinson's, Alzheimer's disease, and so on. 3.Diagnosed with severe anxiety disorder, depression, and using antipsychotic symptomatic drugs to treat patients. 4.Individuals who could not read or write; the presence of speech or visual function or hearing dysfunction; patients with dementia.

研究实施时间:

Study execute time:

From 2023-07-01 00:00:00 To 2026-06-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2023-11-13 00:00:00 To 2024-11-15 00:00:00

干预措施:

Interventions:

组别:

对照组

样本量:

25

Group:

Control group

Sample size:

干预措施:

患者接受缺血性脑卒中常规治疗、康复与护理如常规内科治疗、常规康复治疗、常规饮食指导、护理安全、健康教育、心理护理等。

干预措施代码:

Intervention:

The control group was given routine treatment, rehabilitation and nursing care for ischaemic stroke, mainly including condition observation, safety care, health education on disease knowledge and limb function rehabilitation.

Intervention code:

组别:

重复经颅磁刺激组

样本量:

25

Group:

rTMS group

Sample size:

干预措施:

由康复治疗师行rTMS治疗。①设备:武汉奥赛福公司的经颅磁刺激仪,带圆形线圈。②核对患者,取仰卧位或侧卧位,告知配合要点。③rTMS治疗:首次刺激测定静息运动阈值(relaxed motor threshold,RMT),设置频率为10 Hz,强度为100% RMT,刺激时间4 s,间隔时间26 s,刺激个数40个,重复40次。定位在左前额叶背外侧,将线圈与患者颅骨表面相切。每次20 min,每天1次,共15 d。④治疗时观察有无出现头痛、耳鸣等不良反应,如有不适及时处理。

干预措施代码:

Intervention:

The rTMS group used the equipment of Wuhan YRD CCY-II transcranial magnetic stimulator with round coil.Before the operation, the patient was verified, supine position or lateral position was taken, and the points of cooperation were informed.The first stimulation of rTMS treatment was used to determine the resting motor threshold (RMT), set at a frequency of 10 Hz and an intensity of 100% RMT, with a stimulation time of 4 s, an interval of 26 s, and a number of stimuli of 40, repeated 40 times. Positioned at the dorsolateral aspect of the left prefrontal lobe, the coil was tangent to the patient's skull surface. 20 min each time, once a day, for 15 d in total.

Intervention code:

组别:

认知训练组

样本量:

25

Group:

Cognitive training

Sample size:

干预措施:

在对照组的基础上,经认知治疗师培训合格的研究者按照卡片式Stroop认知训练流程训练:①准备:Stroop范式任务卡片、指示棒、计时器等。病房环境安静、明亮。采用Stroop范式中色词任务、数字任务、空间任务等,在PPT中绘制,A4纸打印,制作成训练卡片。②告知患者注意事项,取得配合,取舒适体位。③每组任务包括一致性任务和不一致性任务,其中一致性任务无冲突干扰,如色词测试中,“红”字的颜色为红色;不一致任务有冲突干扰,如“红”字用黄色呈现。为了更好地产生Stroop效应,每项任务开始时使用一致性任务,可重复3~5次,再进行不一致性任务。④训练时观察患者有无不适,如有不适及时处理。合理安排休息,给予口头表扬或奖励康复小礼物,提高患者的依从性。⑤每次训练40 min,每天2次,共15 d。

干预措施代码:

Intervention:

The cognitive training group was conducted by a transcognitive therapist.Before the training, the patients were informed of the precautions to be taken to obtain cooperation and to take a comfortable position.Cognitive training mainly used the training cards of colour word task, number task and spatial task in Stroop paradigm. Each group of tasks consisted of a consistency task and an inconsistency task, where the consistency task was free of conflictual interference. In order to produce a better Stroop effect, use the consistency task at the beginning of each task, which can be repeated three to five times, and then proceed to the inconsistency task. Verbal praise or a small rehabilitation gift was given after training to improve patient compliance. Each training session lasted for 40 min, twice a day for 15 d. The patients were given the opportunity to practice the exercises in the morning and evening.

Intervention code:

组别:

联合组

样本量:

25

Group:

Combined group

Sample size:

干预措施:

重复经颅磁刺激联合认知训练组按照rTMS、卡片式Stroop认知训练流程训练:rTMS能快速提高大脑兴奋性,为神经活动提供基础,故二者联合应用时,先由康复治疗师行rTMS,再由研究者行认知训练,即每日上午行rTMS后立即进行卡片式Stroop范式训练,当日下午进行第2次卡片式Stroop范式训练。

干预措施代码:

Intervention:

The combined group was trained according to the rTMS, cognitive training process. The rTMS was performed by the rehabilitation therapist first, and then the cognitive training was performed by the researcher. The card Stroop paradigm was performed immediately after rTMS in the morning of each day, and the 2nd card Stroop paradigm was performed in the afternoon of the same day.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

海南 

市(区县):

海口 

Country:

China

Province:

Hainan

City:

Haikou

单位(医院):

海南医科大学第一附属医院 

单位级别:

三甲 

Institution
hospital:

The first affiliated hospital of Hainan Medical University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

认知功能

指标类型:

主要指标

Outcome:

Cognitive function

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

淡漠症状

指标类型:

次要指标

Outcome:

Apathy

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

结束

/Completed

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

研究者用SPSS22.0 生成随机数字。

Randomization Procedure (please state who generates the random number sequence and by what method):

The researcher used SPSS 22.0 to generate random numbers.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

开放标签,对评估者隐藏分组

Blinding:

Open labelling, hidden grouping of evaluators.

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

ResMan,论文发表后一年内, http://www.medresman.org.cn/login.aspx。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

ResMan, within one year of publication, http://www.medresman.org.cn/login.aspx.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

纸质版收集、保存,并将资料录入电脑保存。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

The paper version collects and maintains the information and enters it into the computer for safekeeping.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2025-05-21 15:35:20