低频重复经颅磁刺激对脑梗死患者运动功能恢复的影响

Effect of low-frequency repetitive transcranial magnetic stimulation on recovery of motor function in patients with cerebral infarction

目的探讨低频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对急性脑梗死患者运动功能恢复的影响。方法选取44例急性脑梗死伴偏瘫的住院患者,随机分为低频刺激组和对照组。低频治疗组接受10次1 Hz rTMS治疗,患者在rTMS治疗后均进行运动功能训练。在治疗前、第10天、第40天对所有患者进行临床功能NIHSS评分、Barthel指数(BI)、Fugl-Meyer评分(FMA)。结果治疗前两组间NIHSS、BI、FMA比较差异不具有统计学意义(P>0.05)。经过治疗,两组的临床功能评分(NIHSS、BI、FMA)在治疗后第10天和40天时均较治疗前改善(P<0.01)。治疗后第10天和第40天时两组间的NIHSS、BI、FMA比较差异有统计学意义(P<0.01),其中,低频刺激组的运动功能恢复明显优于对照组。结论低频rTMS对急性期脑梗死后运动功能的恢复有促进作用,其效果在治疗结束后1个月仍然存在。

Objective To investigate the effect of low-frequency repetitive transcranial magnetic stimulation（rTMS） on the recovery of motor function in the patients with acute cerebral infarction.Methods A total of forty-four hospitalized patients with acute cerebral infarction combined with hemiparalysis were divided into a low-frequency rTMS group（n=22） and a sham rTMS group（n=22）.The patients of the low-frequency rTMS group were given 10 daily sessions of 1 Hz rTMS over contralesional primary motor cortices.All the patients underwent motor function training after the rTMS treatment.The NIHSS,Barthel index（BI） and Fugl-Meyer assessment（FMA） were performed before and in 10 and 40 d after low-frequency rTMS treatment.Results No significant difference was found in basal rating scales between the two groups（P0.05）.The clinical function scores（NIHSS,BI and FMA） of the two groups improved significantly at days 10 and 40 after treatment（P0.01）.The patients of the low-frequency rTMS group showed more significant improvement in the NIHSS,BI and FMA scores as compared with the patients of the sham rTMS group（P0.05）.Conclusion Low-frequency rTMS can improve the motor function recovery of patients with acute cerebral infarction,with effects lasting for at least one month after treatment.