Objective To explore the effects of repetitive transcranial magnetic stimulation(rTMS) combined with synchronous working memory training on memory，attention，executive function and other cognitive functions in stroke patients. Methods A total of 100 stroke inpatients and outpatients admitted in Department of Rehabilitation Medicine of Hongqi Hospital Affiliated to Mudanjiang Medical College from January 2022 to May 2023 were enrolled and randomly divided into a synchronous group(simultaneous rTMS and working memory training)，a rTMS group，a working memory training group，and a control group(no cognitive training)，there were 25 case in each group. Stroop test，Rivermead behavioral memory test，Montreal cognitive assessment (MoCA)，modified Barthel index(MBI) test，and Fug1}VIeyer test were applied before and after treatment. Results There were no significant differences in above test scores among the four groups before treatment (P＞0.05).After treatment，Stroop test showed that the synchronization group had significantly higher accuracy rates of the baseline phase and the conflict phase than the other three groups （P＜G0.05)，shorter reaction time of the baseline phase than the working memory training group and the control group(1043. 76士260. 38 ms vs 1299.36士468.86 ms and 1418. 68士412.25 ms，P<0.05)，and shorter reaction time of the conflict phase than the control group (P ＜0.05).The synchronization group scored statistically higher scores than the other three groups in the Rivermead behavioral memory test，MoCA test，modified Barthel test，and Fugl-Meyer test (P ＜0.05).Conclusion rTMS combined with synchronous working memory training can effectively improve the cognitive function in stroke patients.

目的 探究重复经颅磁刺激联合同步工作记忆训练对脑卒中患者记忆力、注意力、执行能力等认知功能的影响。方法 选取2022年1月至2023年5月于牡丹江医学院附属红旗医院康复医学科住院和门诊治疗的100例脑卒中患者，采用随机数表法将其分为同步组、重复经颅磁刺激组、工作记忆训练组、对照组，每组25例。针对认知功能，同步组同时进行重复经颅磁刺激和工作记忆训练，重复经颅磁刺激组进行重复经颅磁刺激治疗，工作记忆训练组进行工作记忆训练，对照组进行假性磁刺激治疗。治疗前后分别给予4组患者Stroop测试、Rivermead行为记忆测试、蒙特利尔认知评估量表(MoCA)测试、改良Barthel指数(MBI)测试、Fugl-Meyer测试。结果 治疗前，4组Stroop、Rivermead、MoCA、MBI、Fugl-Meyer测试成绩比较，差异无统计学意义(P>0.05);治疗后同步组Stroop测试基线阶段正确率、冲突阶段正确率显著高于其他3组(P<0.05),基线阶段用时显著短于工作记忆训练组、对照组[(1043.76±260.38)ms vs(1299.36±468.86)ms、(1418.68±412.25)ms,P<0.05],冲突阶段用时显著短于对照组(P<0.05)。同步组Rivermead行为记忆测试、MoCA测试、MBI测试、Fugl-Meyer测试成绩显著高于其他3组(P<0.05)。结论 重复经颅磁刺激联合同步工作记忆训练能有效改善脑卒中患者的认知功能。

国家自然科学基金(31671136)