低频重复经颅磁刺激对脑梗死患者运动功能恢复的影响

目的探讨低频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对急性脑梗死患者运动功能恢复的影响。方法选取44例急性脑梗死伴偏瘫的住院患者,随机分为低频刺激组和对照组。低频治疗组接受10次1 Hz rTMS治疗,患者在rTMS治疗后均进行运动功能训练。在治疗前、第10天、第40天对所有患者进行临床功能NIHSS评分、Barthel指数(BI)、Fugl-Meyer评分(FMA)。结果治疗前两组间NIHSS、BI、FMA比较差异不具有统计学意义(P>0.05)。经过治疗,两组的临床功能评分(NIHSS、BI、FMA)在治疗后第10天和40天时均较治疗前改善(P<0.01)。治疗后第10天和第40天时两组间的NIHSS、BI、FMA比较差异有统计学意义(P<0.01),其中,低频刺激组的运动功能恢复明显优于对照组。结论低频rTMS对急性期脑梗死后运动功能的恢复有促进作用,其效果在治疗结束后1个月仍然存在。

Effect of low-frequency repetitive transcranial magnetic stimulation on recovery of motor function in patients with cerebral infarction

Objective To investigate the effect of low-frequency repetitive transcranial magnetic stimulation(rTMS) on the recovery of motor function in the patients with acute cerebral infarction.Methods A total of forty-four hospitalized patients with acute cerebral infarction combined with hemiparalysis were divided into a low-frequency rTMS group(n=22) and a sham rTMS group(n=22).The patients of the low-frequency rTMS group were given 10 daily sessions of 1 Hz rTMS over contralesional primary motor cortices.All the patients underwent motor function training after the rTMS treatment.The NIHSS,Barthel index(BI) and Fugl-Meyer assessment(FMA) were performed before and in 10 and 40 d after low-frequency rTMS treatment.Results No significant difference was found in basal rating scales between the two groups(P>0.05).The clinical function scores(NIHSS,BI and FMA) of the two groups improved significantly at days 10 and 40 after treatment(P<0.01).The patients of the low-frequency rTMS group showed more significant improvement in the NIHSS,BI and FMA scores as compared with the patients of the sham rTMS group(P<0.05).Conclusion Low-frequency rTMS can improve the motor function recovery of patients with acute cerebral infarction,with effects lasting for at least one month after treatment.