重复经颅磁刺激治疗脑卒中后运动功能障碍相关理论研究进展

Advances in theory research of repetitive transcranial magnetic stimulation in the treatment of motor dysfunction after stroke

如何更有效地促进脑卒中患者上肢运动功能恢复一直是康复医学的研究热点。大量研究表明,重复经颅磁刺激(rTMS)可以通过调控大脑可塑性,恢复受损大脑半球间平衡,从而促进上肢运动功能恢复。然而,临床研究发现大脑受损程度不同,相同治疗方案往往达不到一致的效果。患者卒中位置、损伤程度以及治疗时的刺激部位、频率等因素都是影响治疗效果的相关因素。本文从rTMS治疗脑卒中后患者运动功能障碍的相关理论依据,包括两侧大脑半球交互抑制理论、代偿理论、双相平衡模型以及不同理论之间的区别进行综述,以期为临床精准治疗提供参考。

How to effectively promote the recovery of upper limb motor function in stroke patients has always been a research hotspot in rehabilitation medicine.A large number of studies have shown that repetitive transcranial magnetic stimulation(rTMS)can promote the recovery of upper limb motor function by regulating brain plasticity and restoring the balance between damaged cerebral hemispheres.However,clinical studies have found that different levels of brain damage often result in inconsistent results from the same treatment regimens.The location of stroke,degree of injury,stimulation site and frequency during treatment are all relevant factors affecting the therapeutic effect.This paper reviews the relevant theoretical basis of rTMS in the treatment of motor dysfunction in patients with stroke,including interhemispheric inhibition theory,compensatory theory,bimodal balance-recovery model,and the differences among them,so as to provide reference for clinical precision treatment.