重复经颅磁刺激在脑卒中康复中的临床应用进展

Clinical Application Progress of Repetitive Transcranial Magnetic Stimulation in the Rehabilitation of Stroke

近年来,中国脑卒中的发病率逐年升高,且其所致的神经功能缺损严重影响患者的后期生活质量。重复经颅磁刺激(rTMS)作为一种新型康复治疗手段,广泛应用于脑卒中患者的神经康复治疗。rTMS仪通过线圈产生磁场双向调节大脑兴奋性维持半球间的兴奋性平衡,从而促进损伤皮质的自我修复,改善神经功能。然而,不同的刺激程序有不同的效果,高频的经颅磁刺激能增加皮质兴奋性,低频的刺激则降低皮质兴奋性,因此针对脑卒中后不同神经功能损伤(运动障碍、认知障碍、吞咽困难等),rTMS对应的治疗方案也有所不同。未来,应进一步探索更为高效安全的治疗方案。

In recent years,the incidence of stroke in China has been increasing year by year,and the neural function defect caused by it has seriously affected the quality of life of the patients.Repetitive transcranial magnetic stimulation(rTMS),as a new method of rehabilitation,is widely used in the neurological rehabilitation of stroke patients.rTMS can generate magnetic field by a coil to regulate brain excitability and maintain interhemispheric excitatory balance,promoting the repair of the injured cortex and improving the neurological function.However,different stimulus programs have different effects,high-frequency transcranial magnetic stimulation can increase cortical excitability,while low frequency stimulation reduces cortical excitability,so for different functions of nerve injury after stroke(movement disorders,cognitive disorders,difficult swallowing etc.),rTMS treatment plans are correspondingly different.In the future,more effective and safer treatment should be further explored.