高频重复经颅磁刺激对脑梗死后焦虑及神经功能康复的影响

Effects of high frequency repetitive transcranial magnetic stimulation on anxiety and neural function rehabilitation of patients with acute cerebral infarction

目的探讨高频重复经颅磁刺激(rTMS)对脑卒中后焦虑的临床疗效。方法急性脑梗死后存在焦虑的患者共70例,随机分为治疗组和对照组,每组35例。对照组给予脑卒中后常规药物治疗,治疗组再给予常规药物治疗的同时给予左前额叶背外侧区(DLPFC)高频(10 Hz)rTMS治疗。治疗前后分别采用美国国立卫生院神经功能缺损评分量表(NIHSS)、Barthel指数(BI)和汉密尔顿焦虑量表(HAMA)进行评分。结果治疗组和对照组经过1个疗程(4周)的治疗后,2组患者NIHSS和HAMA评分均较治疗前降低明显,BI明显增高,差异有统计学意义(P<0.05)。结论高频rTMS对脑梗死患者卒中后焦虑具有较好的治疗效果,作为一种无创的治疗措施,值得在临床得到广泛推广。

Objective To observe the therapeutic effects of high frequency repetitive transcranial magnetic stimulation（ r-TMS） on anxiety after acute cerebral infarction. Methods A total of 70 patients with acute cerebral infarction were randomly divided into two groups： control group（ n = 35） and observation group（ n = 35）. The patients in control group were treated by routine drug therapy,however,the patients in observation group,on the basis of control group,were treated by high frequency rTMS（ 10Hz）,with a treatment course of 4 weeks for both groups. The therapeutic effects were assessed by National Institute of Health stroke scale（ NIHSS）,Hamilton anxiety rating scale（ HAMA） and Barthel index（ BI） before and after treatment. Results After 4-week treatment,the scores of NIHSS and HAMA were significantly decreased in both groups,however,the scores of BI were significantly increased,as compared with those before treatment（ P 〈0. 05）. Conclusion The high frequency repetitive transcranial magnetic stimulation has satisfactory therapeutic effects on anxiety after acute cerebral infarction,as an noninvasive treatment way,which is worth using widely in clinical practice.