重复经颅磁刺激治疗帕金森病2年随访

目的随访观察重复经颅磁刺激(r TMS)治疗帕金森病(PD)患者的疗效。方法应用统一PD评分量表第Ⅲ部分(UPDRSⅢ)、Hoehn-Yahr(H-Y)分级、PD非运动症状(NMS)筛查问卷(NMSQ)、PD睡眠量表(PDSS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和简易智能量表(MMSE)对37例应用药物和r TMS治疗的PD患者(r TMS+药物组)及45例单纯药物治疗的PD患者(药物组)在基线和2年随访末的运动症状(MS)和非运动症状(NMS)进行评估,对比分析两组患者病情进展。结果 r TMS+药物组2年随访末H-Y分级较基线显著升高(P 0.05);药物组2年随访末UPDRSⅢ、H-Y分级、HAMD、HAMA评分及左旋多巴等效剂量(LED)较基线均显著升高(P 0.05);对两组2年随访末的症状进行比较,药物组的UPDRSⅢ、H-Y分级、HAMD评分及LED较r TMS+药物组升高显著(P 0.05)。结论规律的r TMS辅助常规抗PD药物治疗可减缓PD进展,优于单纯抗PD药物治疗。

Repetitive transcranial magnetic stimulation in treatment of Parkinson's disease:A two-year follow-up study

Objective To investigate the clinical effect of repetitive transcranial magnetic stimulation (rTMS) in the treatment of Parkinson''s disease (PD). Methods A total of 37 PD patients treated with drugs and rTMS (rTMS+drug group) and 45 PD patients treated with drugs alone (drug group) were enrolled, and motor symptoms (MS) and non-motor symptoms (NMS) were evaluated at baseline and at the end of two-year follow-up using Unified Parkinson''s Disease Rating Scale III (UPDRS III) and Hoehn-Yahr (H-Y) staging, Non-Motor Symptom Questionnaire (NMSQ), Parkinson''s Disease Sleep Scale (PDSS), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Mini-Mental State Examination (MMSE). Disease progression was analyzed and compared between the two groups. Results The rTMS+drug group had a significant increase in H-Y stage from baseline to the end of two-year follow-up (P<0.05), and the drug group had significant increases in the scores of UPDRS III, H-Y stage, HAMD, and HAMA and levodopa equivalent dose (LED) (P<0.05). Compared with the rTMS+drug group at the end of two-year follow-up, the drug group had significant increases in scores of UPDRS III, H-Y stage, and HAMD and LED (P<0.05). Conclusions Regular rTMS assisting conventional anti-PD drug therapy can delay the progression of PD, with a better clinical effect than drug therapy alone.