重复经颅磁刺激对脑瘫患儿功能网络的影响

Influence of repetitive transcranial magnetic stimulation on the functional connectivity of children with cerebral palsy

目的通过功能磁共振成像(fMRI)方法研究重复经颅磁刺激(rTMS)对脑瘫患儿功能网络的影响,为了解rTMS对脑瘫患儿的治疗效果及作用机制提供影像学依据。方法对1例脑瘫患儿进行为期一年的周期性rTMS治疗,刺激频率1Hz,每个治疗周期后进行静息态功能磁共振成像扫描。选取刺激额中回区域为种子点,分析种子点与全脑所有体素的功能连接情况,并将不同治疗阶段的功能网络进行对比分析。结果额中回与全脑的功能连接性随治疗时间逐渐增强,连接区域逐渐增大,尤其是与运动皮层、小脑、楔前叶以及海马的连接范围及强度呈明显的动态变化。结论在前额叶区域对脑瘫患儿进行重复性经颅磁刺激治疗可以有效改善其大脑的功能连接情况,这些结果证明了rTMS对脑瘫患儿的治疗效果。

Objective The purpose of this study was to investigate the influence of repetitive transcranial magnetic stimulation（rTMS） on the functional connectivity of children with cerebral palsy by using functional magnetic resonance imaging（fMRI）.This research will provide some imaging evidence for understanding the efficiency and the mechanism of rTMS.Methods One patient with cerebral palsy received a periodical rTMS treatment for 1year（1Hz for 20min each time）.A resting state functional magnetic resonance imaging was performed after each periodical treatment.The bilateral middle frontal gyrus was selected as a region of interest to calculate the seed-based whole brain functional connectivity.Results The comparison between the functional connectivity results from different treatment period showed the increased connection intensity and area.Especially on motor cortex,cerebellum,precuneus and hippocampus which showed a dynamic changes with the duration of rTMS treatment.Conclusion The whole brain functional connectivity will be improved effectively after the rTMS treatment on frontal area these results can prove the efficiency and effectiveness of rTMS on cerebral palsy.