1Hz重复经颅磁刺激对缺血性脑卒中后上肢运动功能的疗效

Effect of 1Hz Repetitive Transcranial Magnetic Stimulation on Upper Limb Motor Function after Stroke

目的观察1 Hz重复经颅磁刺激(r TMS)对缺血性脑卒中后偏瘫上肢运动功能康复的效果。方法 40例缺血性脑卒中后上肢偏瘫患者被随机分配到治疗组(n=20)和对照组(n=20)。两组均给予常规康复治疗,治疗组采用r TMS刺激健侧皮层M1区,对照组给予假刺激。治疗后采用运动诱发电位(MEPs)、Fugl-Meyer上肢运动功能评分(FMA)和握力进行评定。结果治疗后,治疗组患侧MEPs振幅显著升高(P<0.001)。治疗组握力和FMA评分显著优于对照组(P<0.001),并至少可持续到治疗结束后1个月。所有患者均能耐受10次治疗,无严重不良反应发生。结论 r TMS刺激健侧皮层M1区可改善缺血性脑卒中后偏瘫上肢的运动功能。

Objective To observe the effect of 1 Hz repetitive transcranial magnetic stimulation（r TMS） on upper limb motor function after stroke. Methods 40 patients with ischemic internal carotid artery（ICA） stroke were randomly divided into treatment group（n=20） and control group（n=20）. Both groups received conventional rehabilitation and medication. The treatment group received r TMS while the control group received pseudo stimulation, 1 Hz at 100% resting motor threshold（RMT） over contralesional motor cortex（unaffected side）. The treatment group was tested with motor evoked potentials（MEPs）, and both groups were assessed with Fugl-Meyer Assessment（FMA） and grip strength after treatment. Results The amplitude of MEPs of the unaffected cortex increased in the treatment group after treatment（P〈0.001）. The treatment group improved in grip strength and the scores of FMA in the affected side compared with the control group after treatment（P〈0.001）. No serious side- effect was found. Conclusion r TMS was safe and feasible for patients with ischemic ICA stroke to improve the upper limb motor function.