重复经颅磁刺激改善脑卒中功能障碍的功能磁共振成像研究:Scoping综述

Functional magnetic resonance imaging study about repetitive transcranial magnetic stimulation for dysfunction after stroke:a scoping review

目的对重复经颅磁刺激(rTMS)改善脑卒中功能障碍的功能磁共振成像(fMRI)研究进行Scoping综述,了解rTMS作用的脑机制。方法检索建库至2022年6月1日PubMed、Web of Science、中国知网、万方数据库中有关rTMS改善脑卒中功能障碍的fMRI研究。采用物理治疗证据数据库(PEDro)量表对纳入文献进行质量评价。由2名研究人员筛选文献、整理资料并进行Scoping综述。结果最终纳入14篇文献,均为高质量或极高质量。纳入文献研究设计为临床随机对照试验。研究主要涉及rTMS对脑卒中后各种功能障碍,如偏瘫、失语、吞咽困难、认知损害、抑郁方面的治疗效果和fMRI变化。结论rTMS可以改变脑卒中后大脑皮质的兴奋性和大脑区域之间有效连接,促进大脑功能重组,实现脑卒中后功能障碍的恢复。

Objective To explore the brain mechanism of repetitive transcranial magnetic stimulation(rTMS)on dysfunction after stroke using functional magnetic resonance imaging(fMRI).Methods Literatures about the functional magnetic resonance imaging study about repetitive transcranial magnetic stimulation for dysfunction after stroke were retrieved in PubMed,Web of Science,CNKI and Wanfang data from establishment to June 1st,2021.The quality of the literature was evaluated with Physiotherapy Evidence Database(PEDro)scale.Literature screening,and data extraction were performed by two researchers.Results A total of 14 randomized controlled trials were finally enrolled.They were of high or very high quality.They mainly involved the therapeutic effect and imaging mechanisms of rTMS on dysfunction after stroke.Conclusion rTMS could change the excitability of the cerebral cortex and the effective connections between brain regions after stroke,promote the reorganization of brain function,and achieve the recovery of post-stroke dysfunction.