Effects of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper limb motor dysfunction in patients with subacute cerebral infarction

Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex （M1）. The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.

EFFECTS OF TRANSCRANIAL MAGNETIC STIMULATION ON MOTOR CORTICAL EXCITABILITY AND NEUROFUNCTION AFTER CEREBRAL ISCHEMIA-REPERFUSION INJURY IN RATS

Objective To clarify the effects of repetitive transcranial magnetic stimulation (rTMS) on rat motor cortical excitabi- lity and neurofunction after cerebral ischemia-reperfusion injury. Methods After determined awake resting motor threshold (MT) and motor evoked potentials (MEPs) of right hindlimbs, 20 Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) reperfusion injury, then rTMS were applied to rTMS group (n = 10) at different time, while control group (n = 10) received no stimulation. A week later, MT and MEPs were evaluated again, as well as neurological deficits and infarct volume. The effects of rTMS and MCAO reperfusion injury on these parameters were analyzed. Results After MCAO reperfusion, both MT level and neurological deficit scores increased, distinct focal infarction formed, and latency of MEP elongated. Compared with the control group, the increased extent of MT and neurological scores of rats receiving rTMS were significantly lower (P < 0.05), as well as the infarct volumes reduced significantly(P < 0.05). But MEP was not affected by rTMS obviously. There was a positive linear correlation between postinjury MT and infarct volume (r = 0.64, P < 0.05). Conclusion rTMS may facilitate neurofunction recovery after cerebral ischemia-reperfusion. Postinjury MT could provide prognostic information after MCAO reperfusion injury.

Transcranial magnetic stimulation for schizophrenia: potential and risks

Recently, transcranial magnetic stimulation (TMS) has increasingly been used to investigate the neurobiology of schizophrenia. In those studies, researchers applied TMS in combination with motor evoked potentials (TMS/MEPs) and high density electroencephalograms (TMS/hd-EEG)[1].

Nerve root magnetic stimulation improves locomotor function following spinal cord injury with electrophysiological improvements and cortical synaptic reconstruction

Following a spinal cord injury,there are usually a number of neural pathways that remain intact in the spinal cord.These residual nerve fibers are important,as they could be used to reconstruct the neural circuits that enable motor function.Our group previously designed a novel magnetic stimulation protocol,targeting the motor cortex and the spinal nerve roots,that led to significant improvements in locomotor function in patients with a chronic incomplete spinal cord injury.Here,we investigated how nerve root magnetic stimulation contributes to improved locomotor function using a rat model of spinal cord injury.Rats underwent surgery to clamp the spinal cord at T10;three days later,the rats were treated with repetitive magnetic stimulation(5 Hz,25 pulses/train,20 pulse trains)targeting the nerve roots at the L5-L6 vertebrae.The treatment was repeated five times a week over a period of three weeks.We found that the nerve root magnetic stimulation improved the locomotor function and enhanced nerve conduction in the injured spinal cord.In addition,the nerve root magnetic stimulation promoted the recovery of synaptic ultrastructure in the sensorimotor cortex.Overall,the results suggest that nerve root magnetic stimulation may be an effective,noninvasive method for mobilizing the residual spinal cord pathways to promote the recovery of locomotor function.

Effects of paired associative magnetic stimulation between nerve root and cortex on motor function of lower limbs after spinal cord injury:study protocol for a randomized controlled trial

Classic paired associative stimulation can improve synaptic plasticity,as demonstrated by animal expe riments and human clinical trials in spinal cord injury patients.Paired associative magnetic stimulation(dual-target peripheral and central magnetic stimulation)has been shown to promote neurologic recove ry after stroke.However,it remains unclear whether paired associative magnetic stimulation can promote recovery of lower limb motor dysfunction after spinal cord injury.We hypothesize that the curre nt caused by central and peripheral magnetic stimulation will conve rge at the synapse,which will promote synapse function and improve the motor function of the relevant muscles.Therefore,this study aimed to examine the effects of paired associative magnetic stimulation on neural circuit activation by measuring changes in motor evoked and somatosensory evoked potentials,motor and sensory function of the lower limbs,functional health and activities of daily living,and depression in patients with spinal co rd injury.We will recruit 110 thora cic spinal trauma patients treated in the Department of Spinal Cord Injury,China Rehabilitation Hospital and randomly assign them to expe rimental and control groups in a 1:1 ratio.The trial group(n=55)will be treated with paired associative magnetic stimulation and conventional rehabilitation treatment.The control group(n=55)will be treated with sham stimulation and co nventional rehabilitation treatment.Outcomes will be measured at four time points:baseline and 4,12,and 24 wee ks after the start of inte rvention(active or sham paired associative magnetic stimulation).The primary outcome measure of this trial is change in lower limb American Spinal Injury Association Impairment Scale motor function score from baseline to last follow-up.Secondary outcome measures include changes in lower limb American Spinal Injury Association sensory function sco re,motor evoked potentials,sensory evoked potentials,modified Ashwo rth scale score,Maslach Burnout Invento ry score,and Hamilton Depression Scale score over time.Motor evoked potential latency reflects corticospinal tract transmission time,while amplitude reflects recruitment ability;both measures can help elucidate the mechanism underlying the effect of paired associative magnetic stimulation on synaptic efficiency.Adve rse events will be recorded.Findings from this trial will help to indicate whether paired associative magnetic stimulation(1)promotes recove ry of lower limb sensory and motor function,reduces spasticity,and improves quality of life;(2)promotes neurologic recovery by increasing excitability of spinal cord motor neurons and stimulating synaptic plasticity;and(3)improves rehabilitation outcome in patients with spinal cord injury.Recruitment for this trial began in April 2021 and is currently ongoing.It was approved by the Ethics Committee of Yangzhi Affiliated Rehabilitation Hospital of Tongji University,China(approval No.YZ2020-018)on May 18,2020.The study protocol was registered in the Chinese Clinical Trial Registry(registration number:ChiCTR2100044794)on March 27,2021(protocol version 1.0).This trial will be completed in April 2022.

右侧顶叶低频重复经颅磁刺激治疗焦虑失眠的随机对照研究

目的探讨右侧顶叶低频重复经颅磁刺激(rTMS)对焦虑失眠患者的治疗效果及其机制。方法随机将60例焦虑失眠患者分为研究组和对照组,研究组采用1 Hz rTMS刺激右侧顶叶皮层,每次2000脉冲,共20次治疗,对照组采用与研究组相同的刺激设备、参数及次数,但将刺激线圈旋转90度,使其垂直于患者头皮,保证磁刺激不能实际作用于大脑的同时又有刺激声音输出。比较治疗前后两组的汉密尔顿焦虑量表(HAMA)评分和匹兹堡睡眠质量指数(PSQI)评分的变化以及事件相关电位失匹配负波(MMN)、P300的潜伏期及波幅的变化,分析治疗前后各项指标及其变化值之间的相关性。结果研究组治疗后HAMA、PSQI评分均较治疗前降低(P<0.05)。研究组治疗后MMN和P300的潜伏期较治疗前缩短,波幅增高(P<0.05)。研究组治疗前后HAMA评分的差值与PSQI评分的差值呈正相关(P<0.01)。研究组治疗前后P300波幅差值与HAMA评分差值呈正相关(P<0.05)。结论右侧顶叶低频rTMS对焦虑失眠患者有确切疗效,可改善患者的焦虑状态、睡眠质量及认知功能,P300的波幅变化可作为焦虑症状改善的生物学指标。

轻度认知功能障碍患者不同频率重复经颅磁刺激康复治疗效果研究

目的:观察不同频率重复经颅磁刺激(rTMS)对老年轻度认知功能障碍(MCI)患者精神行为症状的影响以及康复治疗效果评价。方法:采用随机数字表法,将90例伴有精神行为症状的MCI患者随机分为3组,分别给予5 Hz、10 Hz和15 Hz的rTMS治疗6周(30次),分别于治疗前后测定并比较患者简易精神状态检查(MMSE)分值、P300、错误相关负电位(ERN)的潜伏期和波幅。结果:与治疗前相比:(1)10 Hz组患者rTMS治疗后MMSE量表分值明显增高(P<0.05),而5 Hz和15 Hz组MMSE量表分值无明显改善;(2)10 Hz组患者rTMS治疗后P300和ERN波幅提高(P均<0.05);潜伏期两组差异无统计学意义(P>0.05),其余两组治疗前后P300和ERN潜伏期和波幅均未见明显变化。(3)10 Hz患者组MMSE分值的改善状况与患者年龄及病程有关。结论:高频10 Hz的rTMS对MCI患者精神行为症状具有明显缓解作用,同时能改善患者认知功能,该高频疗法值得临床进一步推广。P300和ERN可用于随访评估。

Effects of cortical intermittent theta burst stimulation combined with precise root stimulation on motor function after spinal cord injury: a case series study

Activation and reconstruction of the spinal cord circuitry is important for improving motor function following spinal cord injury.We conducted a case series study to investigate motor function improvement in 14 patients with chronic spinal cord injury treated with 4 weeks of unilateral(right only)cortical intermittent theta burst stimulation combined with bilateral magnetic stimulation of L3-L4 nerve roots,five times a week.Bilateral resting motor evoked potential amplitude was increased,central motor conduction time on the side receiving cortical stimulation was significantly decreased,and lower extremity motor score,Berg balance score,spinal cord independence measure-III score,and 10 m-walking speed were all increased after treatment.Right resting motor evoked potential amplitude was positively correlated with lower extremity motor score after 4 weeks of treatment.These findings suggest that cortical intermittent theta burst stimulation combined with precise root stimulation can improve nerve conduction of the corticospinal tract and lower limb motor function recovery in patients with chronic spinal cord injury.

重复经颅磁刺激对阿尔茨海默病小鼠海马齿状回钾离子通道的影响

背景:经颅磁刺激已经被用于治疗阿尔茨海默病,但其机制尚未完全明确。目的:分析重复经颅磁刺激对阿尔茨海默病小鼠海马齿状回神经兴奋性的作用机制。方法:采用随机数字表法,将16只C57BL/6小鼠随机分为对照组(n=8)、对照+磁刺激组(n=8),将16只APP/PS1小鼠随机分为痴呆组(n=8)、痴呆+磁刺激组(n=8),对照+磁刺激组与痴呆+磁刺激组给予重复经颅磁刺激,2 h/d,连续刺激14 d。磁刺激结束后,采用水迷宫实验检测小鼠认知能力,全细胞膜片钳技术采集动作电位,分析阿尔茨海默病对动作电位的影响;全细胞膜片钳技术采集钾离子通道电流,分析其动力学特性对神经兴奋性的作用。结果结论:①水迷宫实验结果显示,正常小鼠接受重复经颅磁刺激后能够更加精准地找到确定原平台位置,阿尔茨海默病导致小鼠学习记忆能力下降,找到平台次数下降,海马齿状回神经元退化,而重复经颅磁刺激可提高阿尔茨海默病小鼠的学习记忆能力;②全细胞膜片钳技术检测结果显示,重复经颅磁刺激能够使阿尔茨海默病小鼠神经元更容易发生去极化,使神经元更易兴奋;③钾离子通道电流分析结果显示,阿尔茨海默病使得瞬时外向钾通道半数激活电压增大,失活曲线向着去极化方向偏移,复活时间常数延长,使得延迟整流钾通道激活曲线向着去极化的方向偏移,而重复经颅磁刺激干预延迟了钾离子通道的打开与关闭,抑制了细胞内钾离子的外流,使得细胞内保持较高浓度K^(+),提高了神经元兴奋性;④结果表明,重复经颅磁刺激可能通过提高海马齿状回颗粒神经元兴奋性来缓解认知能力的衰退。

电针上肢穴位对运动皮层躯干脑区皮质脊髓兴奋性的影响

目的观察电针上肢穴位对健康受试者初级运动皮层(primary motor cortex,M1)躯干脑区皮质脊髓兴奋性的影响。方法纳入15名健康受试者,采用交叉设计。试验一观察电针上肢穴位对竖脊肌(erector spinae,ES)皮质脊髓兴奋性的影响,受试者随机先后进入3组试验,A组电针合谷穴,B组电针孔最穴,C组假针合谷穴。运用经颅磁刺激,检测干预前后对侧M1第一骨间背侧肌、桡侧腕屈肌及ES的运动诱发电位(motor evoked potentials,MEPs)的波幅和潜伏期,ES的MEPs波幅升高者进入试验二。试验二为抑制背侧前运动皮层(premotor cortex,PMd)后电针上肢穴位对ES的皮质脊髓兴奋性的作用研究,受试者随机先后进入两组试验,D组采用抑制PMd配合电针合谷穴干预,E组采用抑制PMd配合电针孔最穴干预。观察并比较两组对侧M1上肢脑区和躯干脑区MEPs的波幅和潜伏期。结果A组和B组干预后上肢脑区及躯干脑区MEPs总波幅均较同组干预前显著增加(P<0.001,P<0.01)。A组干预后上肢脑区及躯干脑区MEPs总波幅均明显高于C组,B组干预后仅躯干脑区MEPs总波幅明显高于C组,差异均具有统计学意义(P<0.001)。D组干预后上肢脑区最佳刺激点MEPs平均波幅及总波幅较同组干预前均显著增加(P<0.05)。D组和E组干预前后躯干脑区最佳刺激点的MEPs平均波幅及总波幅比较,差异也均无统计学意义(P>0.05)。结论生理状况下,电针合谷、孔最穴均可增强ES的皮质脊髓兴奋性,二者之间无明显差异,PMd可能参与其过程。

不同频率重复经颅磁刺激治疗精神分裂症患者疗效及对事件相关电位P300的影响研究

目的探讨不同频率重复经颅磁刺激(rTMS)治疗精神分裂症患者疗效及对事件相关电位P3波(P300)的影响。方法选取112例精神分裂症患者,按照随机数字表法分为三组:5 Hz组(n=38)、10 Hz组(n=37)、15 Hz组(n=37)。所有患者均维持原用抗精神病药物治疗剂量不变,在此基础上对应给予频率为5 Hz、10 Hz、15 Hz的rTMS治疗,持续治疗5周。治疗后,比较三组患者的疗效、P300潜伏期和波幅、认知功能以及不良反应的差异。结果治疗后,10 Hz组患者的治疗有效率均高于5 Hz组和15 Hz组,P300水平中的波幅和认知功能评分均高于5 Hz组和15 Hz组,差异均有统计学意义(χ^(2)分别=4.82、6.19,t分别=3.57、9.01、2.07、5.46,P均<0.05),且10 Hz组患者的副反应量表(TESS)总分均低于5 Hz组和15 Hz组,差异均有统计学意义(t分别=5.50、6.45,P均<0.05)。5 Hz组和15 Hz组间的治疗有效率、P300波幅、认知功能评分和TESS总分比较,差异均无统计学意义(χ^(2)=0.11,t分别=1.78、1.93、1.38,P均>0.05)。结论与5 Hz、15 Hz的rTMs相比,频率为10 Hz的rTMS疗效更好,能显著改善精神分裂症患者主要症状、P300水平、认知功能,且安全性更高。

耳甲电针对新型冠状病毒感染后睡眠障碍患者大脑皮质兴奋性的调节作用

目的:探讨耳甲电针对新型冠状病毒感染后睡眠障碍患者大脑皮质兴奋性的调节作用。方法:选取2022年6月至2023年6月广东省佛山市第八人民医院金沙分院中医科和康复科门诊失眠患者和健康志愿者各20例作为研究对象,采用匹兹堡睡眠质量指数(PSQI)量表和过度觉醒量表(HAS)来评估受试者的一般情况,同时利用单脉冲经颅磁刺激技术,采集2组受试者经耳甲电针治疗前后的皮层运动诱发电位相关指标,观察耳甲电针对皮层运动诱发电位潜伏期和波幅的调节作用。结果:治疗前观察组与对照组比较,患者的皮层运动诱发电位潜伏期短,波幅大;治疗后,患者的皮层运动诱发电位潜伏期未见显著变化,但波幅有所下降。结论:耳甲电针可以通过激活自主神经系统,调节大脑皮质兴奋性,从而抑制新型冠状病毒感染后睡眠障碍患者大脑皮质过度觉醒状态,可能是耳甲电针治疗失眠的机制之一。

20 Hz重复经颅磁刺激在改善阿尔茨海默症患者认知功能中的应用及其对血清炎性因子的影响

目的:探讨20 Hz重复经颅磁刺激(Repetitive transcranial magnetic stimulation,rTMS)在改善阿尔茨海默症(Alzheimer's disease,AD)患者认知功能中的应用及其对血清炎性因子的影响.方法:选取2021年2月至2022年12月期间我院收治的96例AD患者作为研究对象,按照随机数字表法分为对照组和观察组,各48例.两组患者均使用常规药物治疗,对照组增加假性刺激治疗,观察组增加20 Hz重复经颅磁刺激治疗.观察两组治疗前后血清炎性因子水平、认知功能、事件相关电位(Event related potential,ERP)的变化情况以及神经心理状态.结果:治疗后,观察组血清肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-1β(Interleukin-1β,IL-1β)水平明显较对照组低(P<0.05);观察组P300波幅明显高于对照组(P<0.05);观察组P300潜伏期明显短于对照组(P<0.05);观察组蒙特利尔认知评估量表(Montreal cognitive assessment scale,MoCA)得分明显高于对照组(P<0.05);观察组阿尔茨海默病评定量表认知分表(Alzheimer's disease rating scale cognitive scale,ADAS-cog)、神经精神问卷(Neuropsychiatric Inventory,NPI)得分明显低于对照组.结论:20 Hz rTMS应用于AD患者可以降低机体的炎症反应,改善ERP情况、认知功能和神经心理状态.

运动神经元病和帕金森病的经颅磁刺激运动诱发电位分析与疾病分型和病程的相关性研究

目的探讨运动神经元病和帕金森病的经颅磁刺激运动诱发电位(TMS-MEP),分析与疾病分型和病程的相关性。方法共收集2020年7月至2024年3月在安徽中医药大学神经病学研究所附属医院住院的运动神经元病(MND)患者20例(MND组),帕金森病(PD)患者12例(PD组),以及同期健康体检者10名(正常对照组),均行经颅磁刺激TMS-MEP检查,并收集临床资料。比较3组受试者MEP波幅、MEP潜伏期以及MEP波形参数,采用Pearson相关性分析MEP波幅、MEP潜伏期参数与病程的相关性。结果肌萎缩侧索硬化(ALS)患者首发症状以上肢无力、下肢无力为主,而PD患者首发症状以上肢、下肢抖动僵硬为主。ALS组、PD组、对照组的MEP潜伏期、MEP波幅差异有统计学意义,其中PD组MEP潜伏期相较对照组无差异(P>0.05),而明显低于ALS组(P<0.05)。PD组MEP波幅低于对照组,高于对ALS组(P<0.05)。ALS和PD患者的MEP波形存在差异(P<0.05),其中ALS组患者以2级为主,而PD患者以1级为主。Pearson相关性分析显示,ALS患者MEP潜伏期与病程呈正相关性(r=0.539,P<0.05),PD患者MEP波幅与病程呈负相关性(r=-0.438,P<0.05)。结论TMS-MEP检查可有效评估PD、ALS。ALS患者MEP潜伏期明显增加,波幅明显减低,病程越长则MEP潜伏期越长;PD患者MEP潜伏期较健康人群无明显变化,而波幅略有降低,病程越长MEP波幅降低越明显。

经颅磁刺激联合药物干预在难治性精神分裂症患者中的治疗效果及对事件相关电位和认知功能的影响研究

目的 探讨经颅磁刺激联合药物干预在难治性精神分裂症患者中的治疗效果及对事件相关电位和认知功能的影响。方法 目的选取新疆石河子绿洲医院于2019年12月—2023年12月期间住院治疗的难治性精神分裂症患者300例为研究对象,并按照治疗方法不同分为观察组、对照组,其中对照组患者采取单一氨磺必利治疗,观察组患者联合应用经颅磁刺激处理,分析两组临床应用价值。结果 观察组临床疗效98.00%(147/150)优于对照组84.00%(126/150),差异有统计学意义(χ^(2)=17.949,P<0.05)。观察组治疗后完成分类数较对照组高,其余各维度评分均低于对照组,观察组治疗后靶潜伏期P3及N2较对照组下降,观察组治疗后社会功能评分较对照组提升,差异有统计学意义(P均<0.05)。结论 难治性精神分裂症患者采取经颅磁刺激与药物联合指导能够提高临床治疗效果,同时改善患者自身认知功能。

Combining Motor Imagery and Action Observation with Vibratory Stimulation Increases Corticomotor Excitability in Healthy Young Adults

Vibratory stimulation but also motor imagery and action observation can induce corticomotor modulation, as a bottom-up stimulus and top-down stimuli, respectively. However, it remains unknown whether the combination of motor imagery, action observation, and vibratory stimulation can effectively increase corticomotor excitability. This study aimed to investigate the effect of motor imagery and/or action observation, in the presence or absence of vibratory stimulation, on the corticomotor excitability of healthy young adults. Vibratory stimulation was provided to the palm of the right hand. Action observation consisted in viewing a movie of someone else’s finger flexion and extension movements. The imagery condition required the participants to imagine they were moving their fingers while viewing the movie and attempting to move their fingers in accordance with the movie. Eleven right-handed healthy young adults were asked to perform six conditions randomly: 1) vibratory stimulation, imagery, and action observation, 2) vibratory stimulation and action observation, 3) vibratory stimulation and viewing of a blank screen, 4) imagery and action observation, 5) action observation, and 6) viewing of a blank screen. Single-pulse transcranial magnetic stimulation was conducted to assess corticomotor excitability and the peak-to-peak amplitude of the motor evoked potentials. The results showed that vibratory stimulation increases corticospinal excitability. The findings further revealed that performing motor imagery while viewing finger movement is more effective at inducing an augmentation of corticomotor excitability compared to action observation alone. Thus, the combination of motor imagery, action observation, and vibratory stimulation can effectively augment corticomotor excitability.

Effect of Paired Associative Stimulation on Motor Cortex Excitability in Rats

Paired associative stimulation (PAS),combining transcranial magnetic stimulation (TMS) with electrical peripheral nerve stimulation (PNS) in pairs with an optimal interstimulus interval (ISI)in between,has been shown to influence the excitability of the motor cortex (MC)in humans.However,the underlying mechanisms remain unclear.This study was designed to explore an optimal protocol of PAS,which can modulate the excitability of MC in rats,and to investigate the underlying mechanisms. The resting motor thresholds (RMTs) of TMS-elicited motor evoked potentials (MEPs) recorded from the gastrocnemius muscle and the latency of P1 component of somatosensory evoked potentials (SEPs) induced by electrical tibial nerve stimulation were determined in male Sprague-Dawley rats (n=10).Sixty rats were then randomly divided into 3 groups:a PAS group (further divided into 10 subgroups at various ISIs calculated by using the latency of P1,n=5,respectively),a TMS (only)group (n=5)and a PNS (only)group (n=5).Ninety repetitions of PAS,TMS and PNS were administered to the rats in the 3 groups,respectively,at the frequency of 0.05 Hz and the intensity of TMS at 120% RMT and that of PNS at 6 mA.RMTs and motor evoked potentials'amplitude (MEPamp)were recorded before and immediately after the interventions.It was found that the MEPamp significantly decreased after PAS at ISI of 5 ms (P<0.05),while the MEPamp significantly increased after PAS at ISI of 15ms,as compared with those before the intervention (P<0.05).However,the RMT did not change significantly after PAS at ISI of 5 ms or 15 ms (P>0.05).PAS at other ISis as well as the sole use of TMS and PNS induced no remarkable changes in MEPamp and RMT.In conclusion,PAS can influence motor cortex excitability in rats.Neither TMS alone nor PNS alone shows significant effect.

Ipsilateral motor evoked potentials in a patient with unihemispheric cortical atrophy due to Rasmussen encephalitis

The role of the ipsilaterally descending motor pathways in the recovery mechanisms after unilateral hemispheric damage is still poorly understood. Motor output reorganization was investigated in a 56-year-old male patient with acquired unilateral hemispheric atrophy due to Rasmussen encephalitis. In particular,the ipsilateral corticospinal pathways were explored using focal transcranial magnetic stimulation. In the first dorsal interosseous and wrist extensors muscles, the median amplitudes of the ipsilateral motor evoked potentials induced by transcranial magnetic stimulation in the patient were higher than those of 10 age-matched healthy control subjects. In the biceps brachii muscle, the median amplitudes of the ipsilateral motor evoked potentials were the second largest in the patient compared to the controls. This study demonstrated a reinforcement of ipsilateral motor projections from the unaffected motor cortex to the hemiparetic hand in a subject with acquired unihemispheric cortical damage.

个体化经颅磁刺激方案对孤独症合并睡眠障碍患儿的干预效果观察

目的:探讨个体化经颅磁刺激方案对孤独症合并睡眠障碍患儿的干预效果。方法:选取90例孤独症合并睡眠障碍患儿,随机分为对照组与观察组各45例。2组均接受常规康复治疗,对照组在常规治疗的基础上实施常规重复经颅磁刺激(rTMS)治疗,观察组依据患儿的事件相关电位(ERP)的检查结果进行个体化rTMS治疗;采用儿童孤独症评定量表(CARS)、孤独症治疗评估表(ATEC)、儿童睡眠习惯调查问卷(CSHQ)以及家庭睡眠习惯调查表(FISH)比较2组的干预效果。结果:与治疗前相比,2组患儿治疗后CARS、ATEC评分均显著降低(均P<0.05),且观察组的CARS、ATEC评分均显著低于对照组(均P<0.05);与治疗前相比,2组患儿治疗后CSHQ评分显著降低(均P<0.05),FISH评分显著增加(均P<0.05),且观察组的CSHQ评分显著低于对照组(P<0.05),FISH评分显著高于对照组(P<0.05)。结论:根据ERP结果进行个体化rTMS治疗方案对ASD合并睡眠障碍患儿的干预效果优于常规rTMS治疗。

不同模式经颅磁刺激对大鼠工作记忆中局部场电位因果网络连接的影响

近年来,非侵入式临床神经调控手段被专家学者们重点关注,其中经颅磁刺激技术能够无创地在大脑皮层中诱导出感应电场,从而调节神经系统功能,其对认知功能的调控作用尤为显著。建立5 Hz重复经颅磁刺激(rTMS)组、间歇性θ节律刺激(iTBS)组和连续性θ节律刺激(cTBS)组大鼠模型,每组6只。记录大鼠在工作记忆任务过程中的局部场电位信号(LFPs)。之后,基于定向传递函数(DTF)分别构建θ和γ频段的局部场电位因果连接网络,并计算各组大鼠的DTF值、平均连接密度、全局效率等因果网络特征参数,结合各组行为学的实验结果,对比分析不同模式经颅磁刺激对大鼠工作记忆的影响。结果表明,关于学会工作记忆行为学任务所需时间,rTMS组[(4.83±1.84)d]和iTBS组[(5.00±1.55)d]大鼠显著低于对照组[(7.83±2.40)d]和cTBS组[(9.33±2.07)d](P<0.05);各组间大鼠LFPs信号θ频段的DTF值无统计学差异(P>0.05),rTMS组和iTBS组大鼠γ频段的DTF值等网络参数均显著高于对照组和cTBS组大鼠(P<0.05)。rTMS刺激模式和iTBS刺激模式有助于增强前额叶皮层神经元集群间γ振荡的信息交互,从而改善工作记忆能力,iTBS以及rTMS对认知功能障碍的改善效果优于cTBS。研究结果可为不同模式经颅磁刺激技术的探索提供参考。