运动前区高频重复经颅磁刺激对脑卒中上肢功能康复的疗效

目的探讨运动前区高频重复经颅磁刺激(rTMS)对脑卒中偏瘫患者上肢运动功能恢复的影响。方法2018年8月至2019年7月,60例脑卒中偏瘫患者随机分为对照组(n=30)和观察组(n=30)。两组均进行常规药物治疗及康复训练,观察组给予患侧大脑半球运动前区5 Hz rTMS,共3周。对照组给予伪刺激。治疗前后采用Fugl-Meyer评定量表上肢部分(FMA-UE)、Brunnstrom分期、改良Ashworth量表(MAS)、改良Barthel指数(MBI)和Wolf手功能量表进行评价。结果对照组脱落2例。治疗后,两组FMA-UE、MBI和Wolf手功能量表评分均明显改善(|t|>3.686,P<0.01),观察组治疗前后FMA-UE评分和Wolf手功能量表评分差值大于对照组(|t|>2.119,P<0.05)。结论患侧大脑半球运动前区高频rTMS能促进脑卒中偏瘫患者上肢和手的运动功能恢复。

Effects of High-frequency Repetitive Transcranial Magnetic Stimulation to Premotor Areas on Upper Limb Motor Dysfunction after Stroke

Objective To explore the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function in hemiplegic patients after stroke.Methods From August, 2018 to July, 2019, 60 patients with hemiplegia after stroke were randomly divided into control group (n = 30) and observation group (n = 30). Both groups received conventional treatment. The observation group accepted 5 Hz rTMS to ipsilesional hemisphere premotor areas for three weeks. The control group received sham stimulation. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Brunnstrom stages, modified Ashworth Scale (MAS), modified Barthel Index (MBI) and Wolf Motor Function Test before and after treatment.Results Two patients dropped in the control group. After treatment, the scores of FMA-UE, MBI and Wolf Motor Function Test improved in both groups (|t| > 3.686, P< 0.01), and the difference values of FMA-UE and Wolf Motor Function Test before and after treatment were more in the observation group than in the control group (|t| > 2.119, P< 0.05).Conclusion High-frequency rTMS to ipsilesional hemisphere premotor areas could improve the recovery of upper limb and hand motor function in hemiplegic patients after stroke.