低频重复经颅磁刺激右侧颞上回后部对脑卒中完全性失语患者言语功能的影响

Effects of low frequency rTMS over the right superior temporal gyrus on language function in subacute global poststroke aphasia patients

目的:初步探讨低频重复经颅磁刺激右侧颞上回后部对脑卒中后完全性失语症患者言语功能的影响。方法:将12例受试对象按照随机数字表法分为r TMS组和假刺激组。rTMS组采用低频rTMS刺激右侧颞上回后部,每周5次,每次20min,共治疗3周。假刺激组采用假刺激治疗。分别于治疗前、治疗后3d内、治疗后3个月、6个月对两组患者采用西方失语症失语评定量表(WAB)进行言语功能评估。结果:与假刺激组相比,rTMS组各时间点WAB总分(F=5.023,P=0.030)和听理解分值(F=8.158,P=0.002)的上升幅度差异具有显著性意义。两组患者rTMS治疗后3d、治疗后6个月与治疗前的WAB-AQ总分(t=2.489,P=0.042;t=2.788,P=0.020)、听理解(t=3.800,P=0.003;t=3.532,P=0.005)的差值比较,差异具有显著性意义。结论:低频rTMS刺激右侧颞上回后部能改善亚急性期脑卒中后完全性失语症患者的言语功能,特别是听理解能力改善较明显。

Objective：To explore the effects of low-frequency repetitive transcranial magnetic stimulation （LF-rTMS） over the right superior temporal gyrus on language function in global aphasia patients after stroke. Method： Twelve patients with subacute poststroke aphasia were randomized to a 15-day protocol of 20-minute inhibitory 1Hz rTMS over the right posterior superior temporal gyrus or sham stimulation, followed by a speech and language therapy for 40 minutes. The Western Aphasia Battery （WAB） was used to evaluation at baseline and 3 days, 3 months and 6 months post-stimulation. Result： Compared with the sham stimulation group, the WAB AQ score and auditory comprehension score increased significantly over time in rTMS group（P〈0.05）. The WAB AQ score change and auditory comprehension score between before stimulation and after 3 days, 6 months stimulation were higher in rTMS group than that in sham group（P〈0.05）. Conclusion： Low frequency rTMS over the posterior superior temporal gyrus could significantly improve language recovery, especially for auditory comprehension ability in subacute ischemic stroke with global aphasia.