rTMS联合运动训练对运动皮质功能影响的研究

目的重复经颅磁刺激(rTMS)联合运动训练可有效提高肢体的运动能力。拟通过皮质静息期(CSP)记录的方法探讨rTMS联合运动训练对运动皮质功能的影响,进一步理解其提高运动能力的神经生理机制。方法募集了16例健康受试者,其中男性14例,女性2例;年龄23~31岁,平均年龄24.56岁。随机分为试验组和对照组,试验组进行为期14 d的rTMS联合运动训练,对照组仅进行14 d的运动训练。记录干预前后的CSP信号,并离线提取CSP中运动诱发电位(MEP)的幅值及潜伏期、CSP的持续时间。结果试验组左手MEP的幅值显著增加(z=3,P<0.05),潜伏期显著降低(z=25,P<0.05),CSP持续时间呈增加趋势,但是无统计学意义(z=6,P>0.05)。对照组左手MEP的幅值显著增加(z=4,P<0.05M),EP的潜伏期和CSP的持续时间均无显著变化(P>0.05)。两组受试者右手的MEP幅值、潜伏期和CSP持续时间的变化均无统计学意义(P>0.05)。结论rTMS联合运动训练同时调控了运动皮质兴奋和抑制性神经元的功能,它可能是rTMS联合运动训练提高肢体运动能力的重要原因。

Effect of rTMS combined with motor training on function of motor cortex

Objective To investigate the effects of repetitive transcranial magnetic stimulation(rTMS)combined with motor training on motor cortex function and understand the neural mechanism of its motor ability improvement effect with cortical silent period(CSP)signal recording method.Methods A total of 16 healthy subjects were enrolled,which included 14 males and 2 females,aged 23-31 years old with mean age of 24.56 years old.All of the subjects were randomly divided into experimental group and control group.The experimental group was performed r TMS combined with motor training for 14 days,while control group only performed motor training for 14 days.The CSP signal was recorded before and after intervention,and motor evoked potentials(MEP)amplitude and latency and CSP duration were calculated.Results In experimental group,the amplitude of the left hand MEP increased significantly(z=3,P<0.05),while the latency was significantly reduced(z=25,P<0.05).CSP was increased,but the difference was not statistically significant(z=6,P>0.05).In control group,the amplitude of the left hand MEP increased significantly(z=4,P<0.05).There were no significant changes in the latency of MEP and CSP duration(P>0.05).There were no significant differences in the right hand MEP amplitude,latency and CSP duration between 2 groups(P>0.05).Conclusion It is demonstrated that r TMS combined with motor training modulates motor cortex function of excitability and inhibition,which could be the important reason for improving motor abilities.