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 patien...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.展开更多
目的探讨左侧前额叶背外侧皮质(L-DLPFC)的间断θ短阵快速脉冲(iTBS)模式重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)和传统模式rTMS对精神分裂症患者阴性症状及认知功能的影响。方法选取2018年9月至2020年3月...目的探讨左侧前额叶背外侧皮质(L-DLPFC)的间断θ短阵快速脉冲(iTBS)模式重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)和传统模式rTMS对精神分裂症患者阴性症状及认知功能的影响。方法选取2018年9月至2020年3月哈尔滨精神专科白渔泡医院收治的80例精神分裂症患者作为研究对象,按随机数字表法分为iTBS组(n=40)和rTMS组(n=40)。iTBS组接受iTBS刺激联合药物治疗,rTMS组给予传统模式重复经颅磁刺激联合药物治疗。两组均刺激L-DLPFC,5次/周,治疗4周,共20次。治疗前后,采用阳性与阴性症状量表(PANSS)比较两组患者的阴性症状,采用威斯康星卡片分类测验(WCST)测评两组患者的认知功能。结果与治疗前相比,治疗后两组患者的PANSS阴性量表分数[iTBS组:(29.81±4.02)分比(26.22±3.88)分,t=10.540;rTMS组:(30.91±5.53)分比(27.35±4.99)分,t=9.786]、总分[iTBS组:(78.14±7.59)分比(73.65±5.43)分,t=6.219;rTMS组:(78.88±10.00)分比(75.21±9.14)分,t=9.297]、反应缺乏分数[iTBS组:(15.70±1.71)分比(14.76±1.75)分,t=3.641;rTMS组:(15.56±2.44)分比(14.12±2.03)分,t=7.792]、思维障碍分数[iTBS组:(7.68±1.53)分比(7.32±1.18)分,t=2.837;rTMS组:(7.85±1.84)分比(7.21±1.72)分,t=4.875]、WCST中完成第一个分类所需应答数[iTBS组:128.00(50.50,128.00)比106.00(42.00,128.00),Z=-4.92;rTMS组:128.00(98.25,128)比106.50(36.75,128.00),Z=-4.86]、非持续性错误[iTBS组:87.00(62.50,95.00)比74.00(42.00,91.00),Z=-4.55;rTMS组:89.50(80.75,96.50)比68.00(53.00,82.75),Z=-4.33]均显著降低(P<0.05);与治疗前相比,两组治疗后的WCST中正确应答数[iTBS组:40.00(33.50,57.50)比59.00(53.50,79.50),Z=-4.92;rTMS组:39.50(32.75,46.00)比58.00(46.79,75.50),t=-4.86]、概念化水平百分数[iTBS组:0.09(0.05,0.23)比0.18(0.14,0.34),Z=-5.30;rTMS组:0.08(0.05,0.16)比0.19(0.15,0.24),Z=-5.09]均显著升高(P<0.05)。两组治疗后的PANSS、WCST各项目评分及评分差值比较,差异均无统计学意义(P>0.05)。结论在总刺激数一定的条件下,iTBS及传统模式10 Hz rTMS均能改善精神分裂症患者的阴性症状及认知功能,且疗效相当,但iTBS模式耗时更少。展开更多
基金supported by National Key R&D Program of China,No.2020YFC2004202the National Natural Science Foundation of China,Nos.81974358 and 81772453(all to DSX).
文摘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.
