低频重复经颅磁刺激对首次脑卒中后言语失用的疗效观察

Effect of low frequency repetitive transcranial magnetic stimulation on the treatment of apraxia of speech caused by first cerebral apoplexy

目的探讨低频重复经颅磁刺激(r TMS)治疗首次脑卒中后言语失用的临床疗效。方法将南京脑科医院康复医学科住院的44例脑卒中后言语失用患者按随机数字表法随机分为对照组和r TMS组。两组患者均给予常规的言语功能康复训练,r TMS组在此基础上给予右侧Broca同源区1 Hz的r TMS治疗。于治疗前和治疗3周后选用中国康复研究中心版的言语失用评定标准以及西方失语成套测验(WAB)评定两组患者的治疗效果。结果与治疗前相比,治疗后2组患者言语失用评分及WAB评分均显著提高(均P<0.05);治疗后r TMS组言语失用评分及WAB评分中自发言语评分显著高于对照组(P<0.05)。结论低频重复r TMS刺激右侧Broca同源区可显著改善脑卒中后言语失用患者的言语功能。

Objective To investigate the clinical effect of low frequency repetitive transcranial magnetic stimulation(r TMS)on the treatment of apraxia of speech after first stroke.Methods Forty-four patients with apraxia of speech after stroke were randomly divided into control group or r TMS group.Both groups were given routine speech rehabilitation training.The patients in the r TMS group were treated with 1 Hz r TMS in the right Broca homologous region.Before and after 3 weeks of treatment,the speech loss assessment standard of China Rehabilitation Research Center and the Western Aphasia Battery(WAB)were used to evaluate the therapeutic effect of the two groups.Results After treatment,the speech loss score and WAB score of the two groups were significantly higher than those before treatment(all P<0.05);after treatment,the speech loss score and the spontaneous language score of WAB in r TMS group were significantly higher than those of the control group(P<0.05).Conclusion Low frequency r TMS in the right Broca homologous region can significantly improve the speech function of patients with apraxia of speech after stroke.