低频重复经颅磁刺激对卒中患者非流利型失语症视图命名的影响

目的探讨低频重复经颅磁刺激(rTMS)对卒中恢复期非流利型失语症患者的疗效。方法前瞻性连续纳入2010年10月—2011年12月卒中发病3~6个月的失语患者10例。选用病例治疗前后自身对照的方法,治疗分为A期和B期,A期为常规语言治疗2周,在A期治疗的基础上,B期使用常规语言治疗联合低频rTMS,低频rTMS刺激右侧半球额下回后部2周。在A期治疗前后和B期治疗前后,分别进行汉语失语症心理语言评价中的视图命名测试。结果常规语言治疗后,患者视图命名成绩未见明显提高。继续2周低频rTMS加常规语言治疗,患者的视图命名成绩平均提高中位数7个,与rTMS治疗前比较,差异有统计学意义(P0.05);视图命名的反应时间,平均缩短中位数3.95 s,差异亦有统计学意义(P0.05)。结论低频rTMS刺激患者右侧半球额下回后部,可以提高恢复期失语症患者视图命名的正确率并加快视图命名反应时间。提示低频rTMS治疗对右侧大脑半球失语症的恢复有积极作用。

Effects of low-frequency repetitive transcranial magnetic stimulation on picture naming of non-fluent aphasia in patients with stroke

Objective To investigate the therapeutic effects of low-frequency repetitive transcranial magnetic stimulation （rTMS） on patients with non-fluent aphasia during stroke recovery period. Methods Ten consecutive patients with aphasia at 3 to 6 months after stroke from October 2010 to December 2011 were enrolled prospectively.The comparison methods before and after the treatment for patients were selected for the study.The therapies were divided into phase A and phase B.Phase A was a two-week conventional speech therapy （low-frequency rTMS on the rear of right posterior inferior frontal gyrus）.On the basis of the treatment in phase A,the conventional language therapy in combination with low-frequency rTMS in phase B were conducted for two weeks at the same time.Before and after the treatment in phase A and after the treatment in phase B,the picture naming test in psycholinguistic assessment in Chinese aphasia was conducted. Results There was no significant change in picture naming scores after conventional language therapy.The picture naming scores of the patients were improved after two-week low-frequency rTMS and conventional language therapy.The mean picture naming scores were improved 7 （P＜0.05）.Compared with before rTMS,there was significant difference （P＜0.05）,the reaction time of picture naming was also shortened （an average shortening of 3.95 s）.There was significant difference （P＜0.05）. Conclusion The low-frequency rTMS of the rear of the right inferior frontal gyrus may improve the correct rate of the picture naming and shorten the reaction time of the picture naming in patients with aphasia during the recovery period.This suggests that the low-frequency rTMS stimulation on the right hemisphere has a positive effect on the recovery of aphasia.