低频重复经颅磁刺激对帕金森病运动功能和情感障碍的疗效观察

Effects of low frequency repetitive transcranial magnetic stimulation on motor function and affective disorder in patients with Parkinson＇s disease

目的从运动功能、情感障碍方面观察低频重复经颅磁刺激（rTMS）对帕金森病（PD）患者的治疗作用。方法rTMS组用1HzrTMS技术治疗20例PD患者共15d。10例与rTMS组相匹配的PD患者接受假刺激治疗15d。rTMS、假刺激治疗前后观察统一PD评定量表（UPDRS）、汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）的变化。结果rTMS治疗后20例患者运动功能症状改善良好，UPDRS评分由治疗前的（38．45±17．33）分降至（30．95±17．00）分，降低19．51％，（t=6．780，P〈0．01），UPDRS各项评分下降；HAMD总分由治疗前的（12．15±7．62）分下降到治疗后的（8．75±7．31）分，降低27．98％，（t=5．101，P〈0．01），躯体化、睡眠障碍和阻滞的因子分低于治疗前；HAMA评分无明显改变（t=1．757，P〉0．05）。强直型患者症状改善更为明显。假刺激组治疗前后各项指标差异无统计学意义。结论1Hz rTMS可以改善运动功能和抑郁症状，对焦虑无明显作用。

Objective To investigate the therapeutic effects of low frequency repetitive transcranial magnetic stimulation （rTMS） on motor function and affective disorder in patients with Parkinson＇s disease （PD）. Methods Twenty PD patients were performed by 1Hz rTMS therapy for 15 days and 10 matched patients were performed sham stimulation. Hamilton Depression Scale （HAMD）, Hamilton Anxiety Scale （HAMA） and Unified Parkinson＇ s Disease Rating Scale （UPDRS） were assessed before and 15 days after rTMS treatment. Results After treatment with rTMS, the motor function was improved, and UPDRS total score and UPDRS-Ⅰ, UPDRS-Ⅱ , UPDRS-Ⅲ scores were decreased. UPDRS score was decreased from （38. 45±17.33） to （30.95± 17.00） （t=6.780,P〈0.01）.At the same time, HAMD score was decreased from （12.15±7.62） to （8.75 ± 7.31 ） （t =5. 101, P〈 0.01 ）. The scores of somatization, blockage and sleep disorders were lowered after treatment, but the HAMA score had no significant change（t= 1. 757,P〉0.05）. The rigidity of PD patients was improved obviously. All indexes had no improvement in sham stimulation group. Conclusions Low frequency rTMS may improve motor dysfunction and affective disorder in PD patients .