BACKGROUND Cognitive impairments are core characteristics of schizophrenia,but are largely resistant to current treatments.Several recent studies have shown that highfrequency repetitive transcranial magnetic stimulat...BACKGROUND Cognitive impairments are core characteristics of schizophrenia,but are largely resistant to current treatments.Several recent studies have shown that highfrequency repetitive transcranial magnetic stimulation(rTMS)of the left dorsolateral prefrontal cortex(DLPFC)can reduce negative symptoms and improve certain cognitive deficits in schizophrenia patients.However,results are inconsistent across studies.AIM To examine if high-frequency rTMS of the DLPFC can improve visual memory deficits in patients with schizophrenia.METHODS Forty-seven chronic schizophrenia patients with severe negative symptoms on stable treatment regimens were randomly assigned to receive active rTMS to the DLPFC(n=25)or sham stimulation(n=22)on weekdays for four consecutive weeks.Patients performed the pattern recognition memory(PRM)task from the Cambridge Neuropsychological Test Automated Battery at baseline,at the end of rTMS treatment(week 4),and 4 wk after rTMS treatment(week 8).Clinical symptoms were also measured at these same time points using the Scale for the Assessment of Negative Symptoms(SANS)and the Positive and Negative Syndrome Scale(PANSS).RESULTS There were no significant differences in PRM performance metrics,SANS total score,SANS subscores,PANSS total score,and PANSS subscores between active and sham rTMS groups at the end of the 4-wk treatment period,but PRM performance metrics(percent correct and number correct)and changes in these metrics from baseline were significantly greater in the active rTMS group at week 8 compared to the sham group(all P<0.05).Active rTMS treatment also significantly reduced SANS score at week 8 compared to sham treatment.Moreover,the improvement in visual memory was correlated with the reduction in negative symptoms at week 8.In contrast,there were no between-group differences in PANSS total score and subscale scores at either week 4 or week 8(all P>0.05).CONCLUSION High-frequency transcranial magnetic stimulation improves visual memory and reduces negative symptoms in schizophrenia,but these effects are delayed,potentially due to the requirement for extensive neuroplastic changes within DLPFC networks.展开更多
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 ex...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.展开更多
目的:观察揿针结合重复经颅磁刺激(repeated transcranial magnetic stimulation,rTMS)治疗急性颅脑损伤的效果。方法:选取2020年1月—2023年12月江西省儿童医院收治的60例急性颅脑损伤患儿作为研究对象,采用随机数字表法分为对照组和...目的:观察揿针结合重复经颅磁刺激(repeated transcranial magnetic stimulation,rTMS)治疗急性颅脑损伤的效果。方法:选取2020年1月—2023年12月江西省儿童医院收治的60例急性颅脑损伤患儿作为研究对象,采用随机数字表法分为对照组和观察组,各30例。对照组患儿采用常规针刺结合rTMS治疗,观察组患儿采用揿针结合rTMS治疗。两组均连续干预4周。对比两组临床疗效、肌力、粗大运动功能、肌张力。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗前,两组肌力及粗大运动功能评估量表-88(gross motor function measure,GMFM-88)、改良Ashworth量表(modified Ashworth scale,MAS)评分比较,差异均无统计学意义(P>0.05);治疗1周后及治疗结束后,观察组GMFM-88评分均高于对照组,治疗结束后,观察组MAS评分低于对照组,差异均有统计学意义(P<0.05);治疗结束后,两组肌力均优于治疗前,差异均有统计学意义(P<0.05)。结论:对急性颅脑损伤患儿实施揿针结合rTMS治疗可促进肌力与粗大运动功能恢复,整体疗效突出。展开更多
快感缺失是青少年抑郁障碍的常见临床症状之一,不仅影响了青少年抑郁患者的身心健康,还可能降低临床疗效并导致预后不良,且一线抗抑郁药物对青少年抑郁患者快感缺失症状的疗效较为有限。重复经颅磁刺激(Repeated Transcranial Magnetic ...快感缺失是青少年抑郁障碍的常见临床症状之一,不仅影响了青少年抑郁患者的身心健康,还可能降低临床疗效并导致预后不良,且一线抗抑郁药物对青少年抑郁患者快感缺失症状的疗效较为有限。重复经颅磁刺激(Repeated Transcranial Magnetic Stimulation, rTMS)作为一项安全有效的神经调控物理治疗技术,目前已逐步运用于青少年抑郁障碍的临床干预。本文概述了青少年抑郁障碍快感缺失的形成机制,总结了现有rTMS治疗青少年抑郁障碍的研究并分析rTMS治疗青少年抑郁障碍快感缺失的可行性,最后讨论了现有研究的优点及不足,并对未来研究进行展望。展开更多
基金Supported by Key Diagnosis and Treatment Program of Suzhou,No.LCZX201919 and No.LCZX202016The Scientific and Technological Program of Suzhou,No.SS201752 and No.SS202069Introduction Project of Suzhou Clinical Expert Team,No.SZYJTD201715。
文摘BACKGROUND Cognitive impairments are core characteristics of schizophrenia,but are largely resistant to current treatments.Several recent studies have shown that highfrequency repetitive transcranial magnetic stimulation(rTMS)of the left dorsolateral prefrontal cortex(DLPFC)can reduce negative symptoms and improve certain cognitive deficits in schizophrenia patients.However,results are inconsistent across studies.AIM To examine if high-frequency rTMS of the DLPFC can improve visual memory deficits in patients with schizophrenia.METHODS Forty-seven chronic schizophrenia patients with severe negative symptoms on stable treatment regimens were randomly assigned to receive active rTMS to the DLPFC(n=25)or sham stimulation(n=22)on weekdays for four consecutive weeks.Patients performed the pattern recognition memory(PRM)task from the Cambridge Neuropsychological Test Automated Battery at baseline,at the end of rTMS treatment(week 4),and 4 wk after rTMS treatment(week 8).Clinical symptoms were also measured at these same time points using the Scale for the Assessment of Negative Symptoms(SANS)and the Positive and Negative Syndrome Scale(PANSS).RESULTS There were no significant differences in PRM performance metrics,SANS total score,SANS subscores,PANSS total score,and PANSS subscores between active and sham rTMS groups at the end of the 4-wk treatment period,but PRM performance metrics(percent correct and number correct)and changes in these metrics from baseline were significantly greater in the active rTMS group at week 8 compared to the sham group(all P<0.05).Active rTMS treatment also significantly reduced SANS score at week 8 compared to sham treatment.Moreover,the improvement in visual memory was correlated with the reduction in negative symptoms at week 8.In contrast,there were no between-group differences in PANSS total score and subscale scores at either week 4 or week 8(all P>0.05).CONCLUSION High-frequency transcranial magnetic stimulation improves visual memory and reduces negative symptoms in schizophrenia,but these effects are delayed,potentially due to the requirement for extensive neuroplastic changes within DLPFC networks.
基金several colleague therapists of the Rehabilitation Medicine Department of the Affiliated Hospital of Qingdao University of China for their support and selfless help
文摘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.
文摘目的:观察揿针结合重复经颅磁刺激(repeated transcranial magnetic stimulation,rTMS)治疗急性颅脑损伤的效果。方法:选取2020年1月—2023年12月江西省儿童医院收治的60例急性颅脑损伤患儿作为研究对象,采用随机数字表法分为对照组和观察组,各30例。对照组患儿采用常规针刺结合rTMS治疗,观察组患儿采用揿针结合rTMS治疗。两组均连续干预4周。对比两组临床疗效、肌力、粗大运动功能、肌张力。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗前,两组肌力及粗大运动功能评估量表-88(gross motor function measure,GMFM-88)、改良Ashworth量表(modified Ashworth scale,MAS)评分比较,差异均无统计学意义(P>0.05);治疗1周后及治疗结束后,观察组GMFM-88评分均高于对照组,治疗结束后,观察组MAS评分低于对照组,差异均有统计学意义(P<0.05);治疗结束后,两组肌力均优于治疗前,差异均有统计学意义(P<0.05)。结论:对急性颅脑损伤患儿实施揿针结合rTMS治疗可促进肌力与粗大运动功能恢复,整体疗效突出。
文摘快感缺失是青少年抑郁障碍的常见临床症状之一,不仅影响了青少年抑郁患者的身心健康,还可能降低临床疗效并导致预后不良,且一线抗抑郁药物对青少年抑郁患者快感缺失症状的疗效较为有限。重复经颅磁刺激(Repeated Transcranial Magnetic Stimulation, rTMS)作为一项安全有效的神经调控物理治疗技术,目前已逐步运用于青少年抑郁障碍的临床干预。本文概述了青少年抑郁障碍快感缺失的形成机制,总结了现有rTMS治疗青少年抑郁障碍的研究并分析rTMS治疗青少年抑郁障碍快感缺失的可行性,最后讨论了现有研究的优点及不足,并对未来研究进行展望。
