睡眠脑波调制的与常规的重复经颅磁刺激治疗原发性失眠症的脑电图研究

目的：探讨睡眠脑波调制重复经颅磁刺激与常规重复经颅磁刺激在治疗原发性失眠症中的脑电图（EEG）动态特征及其与临床疗效的关系。方法：按完全随机的方法,将126例原发性失眠症患者分为睡眠脑波调制重复经颅磁刺激组（睡磁组）44例、常规重复经颅磁刺激组（常磁组）42例和假磁刺激治疗组（假磁组）40例。每次持续刺激30min,每日1次,疗程10d。分别观察治疗前、治疗10d时和治疗结束后30d时的Krakow睡眠积分（KSS）、EEG及平均α波绝对功率谱的变化。结果：两磁疗组治疗10d时的KSS显著降低（均P〈0．05）,平均α波绝对功率谱显著升高（均P〈0．05）,尤以睡磁组突出,且持续至治疗结束后30d。治疗10d时磁疗患者平均α波绝对功率谱与其KSS呈显著负相关（n=86,r=0．2136,P〈0．05）。结论：睡眠脑波调制重复经颅磁刺激和常规重复经颅磁刺激对原发性失眠症的异常EEG均有显著的良性调节作用,其疗效与提高平均α波功率谱相关,前者优于后者。     

高、低频重复经颅磁刺激治疗帕金森病伴发抑郁障碍的研究

目的比较高、低频重复经颅磁刺激(r-TMS)治疗帕金森病伴发抑郁障碍的疗效和临床安全性。方法将92例帕金森病伴发抑郁障碍的患者随机分为三组:采用抗震颤麻痹药联合高频(5Hz)重复经颅磁刺激治疗(高频组);采用抗震颤麻痹药联合低频(0.5Hz)重复经颅磁刺激治疗(低频组);采用抗震颤麻痹药联合假性经颅磁刺激治疗(假刺激组)。各组r-TMS每周治疗2次,共治疗4周。每2周评定UPDRS、HAMD-17,记录不良反应,治疗4周后作临床评价。结果入组时三组患者HAMD得分和UPDRS得分差异无显著性(P>0.05)。干预后第2周高频刺激组HAMD得分有明显改善,差异有统计学意义(P=0.0144),第4周差异进一步扩大,差异有极显著性意义(P=0.0000);干预后第2周UPDRSⅡ得分高频、低频和假刺激组差异无统计学意义(P=0.1981),第4周经单因素方差分析差异无统计学意义(P=0.0219)。干预后第2周及第4周UPDRSⅢ得分三组得分差异无统计学意义(P=0.6105、0.4248)。三组不良反应发生率低,无明显差异(P>0.05)。结论左前额叶背外侧高频磁刺激具有改善帕金森患者的抑郁症状,对日常生活的能力亦有所改善,临床疗效确切且不良反应少。     

Effect of r-TMS over standard therapy in decreasing muscle tone of spastic cerebral palsy patients

Spastic cerebral palsy (CP) is the one of most common neurological disorders occurring due to damage to the immature brain or any other brain lesion at the time of birth. To aid in making the life of the CP patient meaningful, several interventions such as medical, surgical and rehabilitation have been employed to date. Besides these, recently repetitive Transcranial magnetic stimulation (r-TMS) is a new found approach which is being employed for treating various neurological and psychological conditions. The aim of this study was to observe the effects of r-TMS on muscle spasticity in CP patients by stimulating the motor cortex area of the brain, which is responsible for muscle movements. In this study, 20 subjects diagnosed with CP were recruited and 10 each were placed in two groups, namely the research group (RG) (mean age, height and weight were 7.99 (SD = 4.66) years, 116.7 (SD = 23.57) cm and 21.40 (SD = 10.95) kg, respectively) and the control group (CG) (mean age, height and weight were 8.41 (SD = 4.32) years, 107.9 (SD = 26.33) cm, 21.40 (SD = 12.63) kg, respectively). r-TMS frequencies of 5?Hz and 10?Hz were administered for 15?min daily to patients in RG followed by standard therapy (ST) of 1?h duration daily for 20 days. Moreover, the patients in the control group (CG) were given only standard therapy (ST) of 1?h duration for 20 days. Modified Ashworth Scale (MAS) was used as an outcome measure to determine the level of muscle spasticity. A pre- assessment of MAS score was performed on both RG and CG to determine the level of spasticity prior to starting therapy; and similarly post-assessment after 20 days was done to observe the changes post-therapy. Statistical analysis of pre vs post MAS scores showed that few muscles showed reduction in muscle tightness after administering only ST in the CG. On the contrary, the RG that underwent r-TMS therapy combined with ST showed a significant decrease (p?相似文献