不同频率重复经颅磁刺激治疗迟发性运动障碍的疗效研究

目的 探讨不同频率重复经颅磁刺激（rTMS）治疗迟发性运动障碍（TD）的疗效.方法 长期服用抗精神病药所致迟发性运动障碍的精神分裂症患者,随机给予1 Hz（低频）和10 Hz（高频）的rTMS治疗4周,每周治疗5d.中间休息2周.分别在治疗前和治疗后进行异常不自主运动评定量表（AIMS）和锥体外系副反应量表（RESES）评定,评分变化作为疗效和副反应评价指标.结果 低频组经rTMS治疗后只有上肢的不自主运动改善[治疗前（2.6±1.0）分,治疗后（1.8±1.1）分],差异有统计学意义（P＜0.05）.高频组经rTMS治疗后多个量表分下降,其中上肢[治疗前（1.9±1.2）分,治疗后（0.8±0.9）分]、唇及口周[治疗前（1.0±0.8）分,治疗后（0.3±0.5）分]和舌[治疗前（2.6±0.9）分,治疗后（1.7±0.9）分]及总量表分[治疗前（7.7±3.0）分,治疗后（4.2±1.7）分]评分治疗前后差异有统计学意义（P＜ 0.05或＜0.01）.另外,两组间在下肢和总量表分减分率方面差异有统计学意义（P＜0.05）.结论 rTMS治疗TD有效,且高频（10 Hz）组治疗TD效果好.

Clinical efficacy of different frequency repetitive transcranial magnetic stimulation for tardive dyskinesia

Objective To investigate the effect of different frequency of repetitive transcranial magnetic stimulation （rTMS）on tardive dyskinesia （TD）.Methods Schizophrenia combined with antipsychotic-induced TD were screened.All patients were planed to receive 1Hz or 10Hz rTMS for 4 weeks in which two weeks＆#39; break was inserted at end of 2nd weekend.The curative effect and side effects were assessed by abnormal involuntary movement scale（AIMS） and rating scale for extrapyramidal side effects（RSESE） respectively at before and after treatment.Results In the 1Hz group,only Involuntary movements of the upper extremities were improved after rTMS treatment （before treatment 2.6± 1.0,after treatment 1.8 ± 1.1）,the difference was statistically significant （P〈0.05）.But in 10Hz group,upper extremities （before treatment 1.9 ± 1.2,0.8 ± 0.9 after treatment）,mouth （before treatment 1.0±0.8,after treatment 0.3±0.5）,tongue（before treatment 2.6±0.9,after treatment 1.7±0.9）,and total score（before treatment 7.7±3.0,after treatment 4.2±1.7） significantly decreased after rTMS treatment（P〈0.05 or 〈0.01）.In addition,the reduction rates in both the lower extremities and the total score was statistically different between the two groups （P〈0.05）.Conclusion rTMS can reduce the symptom of involuntary movement of TD patients and 10Hz rTMS is better.