低频重复经颅磁刺激治疗脑卒中后失眠的疗效

目的 观察低频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗脑卒中后失眠的临床疗效.方法 收集2018年12月至2019年12月武汉大学中南医院康复医学科住院的脑卒中失眠患者58例,男35例,女23例,采用随机数字法将患者分为对照组(n=28)和...     

超低频经颅磁刺激对抑郁症的疗效

目的 评估超低频经颅磁刺激对抑郁症患者的疗效.方法 在某精神卫生中心心身疾病科选择符合〈国际疾病分类（第10版）〉（ICD-10）抑郁发作诊断标准的住院病人共100人,采用简单随机法分为药物联合超低频经颅磁刺激治疗组（研究组）与单纯药物治疗组（对照组）.两组均使用帕罗西汀治疗,研究组联合超低频经颅磁刺激治疗,对照组给予＂伪治疗＂.治疗前和治疗4周分别对所有研究对象进行汉密尔顿抑郁量表（HAMD-17）评定,计算两次量表分差得到减分数.结果 治疗后,研究组HAMD平均得分（8.33±0.76）分,对照组平均得分（7.15±0.62）分,两组间差异有统计学意义（P〈0.05）;研究组平均药物用量为31.18mg/d,对照组为22.14mg/d,两者差异有统计学意义（P〈0.05）;研究组HAMD平均减分数为10.82分,对照组为11.92分,两者差异无统计学意义（P〉0.05）.结论 药物联合超低频经颅磁刺激对抑郁症疗效差于单纯药物治疗,且可能增加抗抑郁剂用量.     

重复经颅磁刺激治疗失眠的临床应用

重复经颅磁刺激（rTMS）是在经颅磁刺激（TMS）技术的基础上发展起来的一项新的神经刺 激技术,它利用电磁感应原理,非侵入性地刺激大脑皮层,改变皮层兴奋性而达到治疗作用。近年来, rTMS在失眠的治疗领域得到广泛的研究和临床运用,并取得了一定的疗效,现结合国内外相关文献, 就rTMS 治疗失眠的临床研究现状进行综述。     

低频重复经颅磁刺激治疗脑卒中后焦虑抑郁共病的疗效

目的研究低频重复经颅磁刺激(rTMS)治疗脑卒中后焦虑抑郁共病的疗效。方法选取卒中后焦虑抑郁共病患者64例,随机为对照组及观察组。对照组采用传统药物方式治疗,观察组在对照组的基础上联合低频重复经颅磁刺激方式治疗。对比2组患者HAMD评分、HAMA评分情况以及治疗总有效率。结果 HAMD评分及HAMA评分从治疗第5天开始观察组均明显低于对照组。对照组有效率为75%,观察组为93.75%,差异有统计学意义(P0.05)。结论低频重复经颅磁刺激方式治疗可明显缓解脑卒中后出现焦虑抑郁障碍患者抑郁、焦虑程度,具有临床推广价值。     

重复经颅磁刺激治疗帕金森病失眠患者临床分析

目的探讨帕金森病合并失眠患者应用重复经颅磁刺激技术治疗的效果及预后。方法选取帕金森合并失眠的患者80例,采取数字表抽取法随机分组,对比分析神经内科常规治疗方案(对照组,n=40)与联合重复经颅磁刺激技术治疗(观察组,n=40)的效果及预后。结果观察组总有效率经评定高于对照组(P<0.05)。2组治疗前帕金森病统一评分量表(UPDRS)各维度评分经评测无显著性差异(P>0.05),治疗后各测验分值均有所降低,观察组降低程度显著低于对照组(P<0.05)。2组治疗前睡眠质量量表(PSQI)各维度评分经评测无显著性差异(P>0.05),治疗后各维度评测分值均不同程度降低,观察组降低程度显著低于对照组(P<0.05)。2组治疗前神经递质多巴胺(DA)、5-羟色胺(5-HT)无显著性差异(P>0.05),治疗后各测验值均有所升高,观察组更为显著(P<0.05)。2组间不良反应比较无明显差异(P>0.05)。结论重复经颅磁刺激可提高帕金森合并失眠患者总有效率,改善临床症状,提高睡眠质量,且具有较高安全性。     

超低频经颅磁刺激联合利培酮对女性精神分裂症的疗效

目的探讨超低频经颅磁刺激联合利培酮对女性精神分裂症患者的疗效。方法将2012年8月-2014年4月在某省精神卫生中心就诊的符合研究标准的60例女性精神分裂症患者按随机数字表法分为研究组(超低频经颅磁刺激联合利培酮治疗,n=30)和对照组(单用利培酮治疗,n=30)。于治疗前、治疗第11天、治疗1月时采用阳性和阴性症状量表(PANSS)对所有患者进行评定。结果两组治疗第11天、1月时的PANSS总评分及各分量表评分均低于治疗前,差异均有统计学意义(P均0.01)。治疗第11天时,研究组的阳性症状量表和幻觉评分均低于对照组(t=2.09,P=0.04;t=2.36,P=0.02);治疗1月时,两组PANSS总评分及各分量表评分差异均无统计学意义(P均0.05)。结论超低频经颅磁刺激联合利培酮对女性精神分裂症患者症状的改善在短期内优于单用利培酮,但其优势并不持久。     

劳拉西泮联合低频重复经颅磁刺激对慢性失眠障碍的效果

目的探讨劳拉西泮联合低频重复经颅磁刺激(rTMS)对慢性失眠障碍的临床疗效,为慢性失眠障碍的治疗提供参考。方法纳入符合《中国失眠障碍诊断和治疗指南》慢性失眠障碍诊断标准的患者120例,按照随机数字表法分为劳拉西泮联合低频rTMS治疗组(研究组)与劳拉西泮联合伪低频rTMS治疗组(对照组)各60例。于治疗前和治疗第4周末进行多导睡眠监测(PSG),于治疗前和治疗第1、2、4周末进行匹兹堡睡眠质量指数量表(PSQI)、汉密尔顿抑郁量表17项版(HAMD-17)和汉密尔顿焦虑量表(HAMA)评定。结果①治疗第4周末,研究组PSQI评分低于对照组(t=-3. 506,P=0. 001),研究组睡眠质量疗效的显效率和有效率均高于对照组(χ~2=4. 658、5. 926,P均0. 05);研究组实际睡眠总时间、睡眠效率均高于对照组(t=2. 333～3. 784,P均0. 05),睡眠潜伏期、觉醒时间、觉醒次数、快速眼球运动睡眠潜伏期均低于对照组(t=-2. 903～-2. 214,P均0. 05)。②治疗第4周末,研究组HAMA评分低于对照组(t=-2. 072,P0. 05);治疗第1、2、4周末,研究组HAMD-17评分均低于对照组(t=-2. 190～-1. 701,P均0. 05)。结论劳拉西泮联合低频rTMS可能有助于改善慢性失眠障碍患者的睡眠质量,并缓解其抑郁、焦虑等负性情绪。     

功能性电刺激结合重复经颅磁刺激用于缺血性脑卒中偏瘫患者步行障碍恢复的临床观察

目的 观察功能性电刺激结合重复经颅磁刺激用于缺血性脑卒中偏瘫患者步行障碍恢复的临床疗效。方法 将53例缺血性脑卒中偏瘫患者随机分为对照组、治疗组、假治疗组3组,在均接受常规康复训练的基础上对照组接受功能性电刺激治疗,治疗组接受功能性电刺激及重复经颅磁刺激治疗,假治疗组接受功能性电刺激及假重复经颅磁刺激治疗; 治疗前及治疗8周后采用步态运动学参数、时间参数、距离参数及Amer-Lindholm分级对3组患者的下肢综合运动功能进行评定。结果 治疗前3组患者步态运动学参数、时间参数、距离参数及Amer-Lindholm分级评分均无显著差异(P>0.05),治疗8周后3组患者上述指标明显改善且治疗组改善幅度明显优于其余2组(P<0.05)。结论 功能性电刺激联合重复经颅磁刺激治疗有利于改善缺血性脑卒中偏瘫患者的步行运动功能。     

重复经颅磁刺激改善缺血性脑卒中运动功能的作用机制

缺血性脑卒中是世界范围内导致长期运动功能残疾的主要原因.脑卒中后运动功能的恢复很大程度上依赖于人脑的可塑性潜力.重复经颅磁刺激(rTMS)是一项能改变人类脑皮质兴奋性的无创、无痛且相对安全的方法,它可通过调整患者脑组织可塑性促进功能康复.此文简要综述rTMS在缺血性脑卒中运动功能恢复中的作用机制.     

高频重复经颅磁刺激治疗卒中后肩手综合征的临床疗效观察

目的 观察高频重复经颅磁刺激(rTMS)治疗卒中后肩手综合征的临床疗效.方法 选取2019年6月至2020年10月在淮安市康复医院康复科病房住院的60例卒中后肩手综合征患者,按照随机数字表法将其分为对照组(30例)和治疗组(30例).两组患者均接受常规止痛治疗和常规康复治疗.对照组在常规治疗的基础上给予伪rTMS治疗,...     

Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke

Repetitive transcranial magnetic stimulation (rTMS) or sham stimulation was given over the motor cortex daily for 10 days to two randomly assigned groups of 26 patients with acute ischemic stroke. Patients otherwise continued their normal treatment. Disability scales measured before rTMS, at the end of the last rTMS session, and 10 days later showed that real rTMS improved patients' scores more than sham.     

Late responses after transcranial magnetic stimulation in stroke

In addition to early responses after transcranial magnetic stimulation, usually designated as Motor Evoked Potentials (MEP), several late responses have been reported in intervals up to 500 ms following stimulus. Our attention in this work was focused on the response in interval 150–300 ms after stimulus output, which is also designated as S > 150 response. We monitored longitudinally late S > 150 response in group of 19 stroke patient with verified hemispherical ischemic lesion. Our results have shown that the presence of late S > 150 response on the first day after stroke predicts an excellent improvement of clinical deficit and that late S > 150 response is more sensitive to hemispheric lesion than early MEPs. From this point of view, recording of late responses can supplement early MEP recording. Our study demonstrated that supratentorial structures are involved in the origin of the S > 150 response. According to the observation that in some patients a normal early response was present and an S > 150 response was absent on the hemiparetic side, and both responses were present on the unaffected side, we hypothesize that cortical structures play an important role in S > 150 response.     

Long-term effect of repetitive transcranial magnetic stimulation on motor function recovery after acute ischemic stroke

Objective –  Although there is evidence for short term benefits of rTMS in stroke, longer term effects have not been reported. The aim of the study was to evaluate the effect of two different frequencies of rTMS on motor recovery and on cortical excitability up to 1 year post-treatment.
Methods –  Forty-eight patients with acute ischemic stroke were randomly classified into three groups. The first two groups received real rTMS over motor cortex (3 and 10 Hz respectively) of the affected hemisphere and the third group received sham stimulation of the same site, daily for five consecutive days. Disability was assessed before, after fifth sessions, and then after 1, 2, 3 and 12 months. Cortical excitability was assessed for both hemispheres before and after the second and fifth sessions.
Results –  A significant 'rTMS × time' interaction was obtained indicating that real and sham rTMS had different effects on rating scales. This was because real rTMS produced greater improvement than sham that was evident even at one year follow-up. These improvements were associated with changes in cortical excitability over the period of treatment.
Conclusion –  These results confirm that real rTMS over motor cortex can enhance and maintain recovery and may be a useful add on therapy in treatment of acute stroke patients.     

Clinical application of repetitive transcranial magnetic stimulation in stroke rehabilitation

Proper stimulation to affected cerebral hemisphere would promote the functional recovery of patients with stroke. Effects of repetitive transcranial magnetic stimulation on cortical excitability can be can be altered by the stimulation frequency, intensity and duration. There has been no consistent recognition regarding the best stimulation frequency and intensity. This study reviews the intervention effects of repetitive transcranial stimulation on motor impairment, dysphagia, visuospatial neglect and aphasia, and summarizes the stimulation frequency, intensity and area for repetitive transcranial magnetic stimulation to yield the best therapeutic effects.     

不同频率重复经颅磁刺激治疗脑卒中后抑郁障碍的疗效观察

目的：探讨低频及高频重复经颅磁刺激（rTMS）对脑卒中后抑郁（PSD）的治疗作用。方法将111例PSD患者随机分为低频组37例（接受1 Hz低频rTMS治疗）、高频组37例（接受10 Hz高频rTMS治疗）和对照组37例（接受假刺激治疗）,每周5次,共治疗4周。于治疗前、治疗第2周末及治疗第4周末分别采用汉密尔顿抑郁量表（HAMD）对3组患者评分。结果 rTMS治疗前,3组HAMD评分差异无统计学意义;治疗后第2、4周末,低频组、高频组 HAMD评分明显低于对照组,特别是高频组;治疗后第2周末,高频组HAMD评分下降幅度较低频组明显。结论低频与高频rTMS治疗PSD安全有效,高频rTMS治疗起效更快。     

The long-term effect of repetitive transcranial magnetic stimulation in the treatment of intractable insomnia

ObjectiveTo explore the differences in clinical efficacy of different courses of repetitive transcranial magnetic stimulation (rTMS) in the treatment of intractable insomnia and the duration of clinical efficacy after cessation of treatment.Method70 patients with intractable insomnia were randomly divided into 1 treatment course group and 2 treatment courses group. The rTMS course consisted of daily sessions of 1200 stimuli for the r-DLPFC at a frequency of 1 Hz and 800 stimuli for parietal lobe (CPZ) at a frequency of 1 Hz. The pitchburg sleep index (PSQI), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and cardiopulmonary coupled sleep (CPC) were assessed for 35 patients in each group at baseline, at 2 weeks, and at 1 and 3 months after treatment.ResultThe scores of PSQI, HAMD and HAMA in the 2 groups were significantly improved after 1 month of follow-up after rTMS treatment (p < 0.01). The long-term effect of different treatment courses is different. After 2 consecutive courses of treatment, there was still a significant difference between the 3-month follow-up and the pre-treatment period (p < 0.05). However, there was no statistical difference between the 3-month follow-up of one course of treatment and the pre-treatment period. The results of CPC test showed that the improvement of total sleep time (TST), and deep sleep time (DST) was basically consistent with the assessment of PSQI, HAMD and HAMA that the clinical efficacy of the 3-month follow-up was better than that of one course of treatment after 2 consecutive courses of treatment.ConclusionThe treatment of refractory insomnia by rTMS is effective, and the duration of the curative effect is related to the course of treatment. 2 consecutive courses of treatment still have a certain effect after 3 months, which is worthy of clinical promotion.     

Clinical effect of repetitive transcranial magnetic stimulation on dysphagia due to stroke

Neurological Sciences - Repetitive transcranial magnetic stimulation (rT) could change the excitability of the cerebral cortex, and control the neurotransmitter release, with the therapeutic effect...