重复经颅磁刺激的累积效应在治疗偏侧忽略中的作用研究

The cumulative effect of repetitive transcranial magnetic stimulation for visual spatial neglect

目的:观察连续数天的低频重复经颅磁刺激在对偏侧忽略患者的治疗中是否产生了累积效应,探讨累积效应是否是低频重复经颅磁刺激治疗偏侧忽略的重要机制。方法:将12例偏侧忽略患者随机分为治疗组和对照组,并对治疗组进行为期10天的低频重复经颅磁刺激治疗,每两天对这12例患者用线段划消和直线二等分测试进行评估,观察治疗组和对照组忽略症状的变化趋势。结果:rTMS的治疗效果和治疗时间之间存在相关关系,治疗组线段划消测试的评估结果和治疗时间之间的相关系数r=-0.659;直线二等分测试中r=-0.606。对照组线段划消测试评估结果和治疗时间之间无相关关系,P>0.05;直线二等分测试结果和治疗时间之间也无相关关系,P>0.05。结论:低频重复经颅磁刺激对偏侧忽略患者症状的改善是一个渐进的过程,具有累积效应,低频重复经颅磁刺激的累积效应在对偏侧忽略患者症状的改善中起到了关键作用。

Objective：To observe the tendency of VSN （visual spatial neglect） patients′ performance after the application of low frequency rTMS and explore if series of consecutive rTMS induce cumulative effect and if the cumulative effect is the important mechanism of the therapeutic method. Method： Twelve VSN patients were divided into treated group and controlled group. The prior group was treated with low-frequency rTMS for ten days and they were asked to perform the line cancellation and line bisection tests every two days. Result： The magnitude of the effect increased with increasing number of rTMS daily sessions. Significant correlations were found between the magnitude of the effect and the number of rTMS sessions. In the treatment group, r=-0.659 and-0.606 for cancellation and bisection test, respectively. There were no correlations between the evaluation results and the increasing time in the controlled group. P =0.531and 0.167 for cancellation test and bisection test, respectively. Conclusion： Consecutive rTMS induces a cumulative effect and the effect plays a key role in the improvement of VSN symptom.