Lefaucheur Jean-Pascal, Fénelon G, Ménard-Lefaucheur I, Wendling S, Nguyen J-P
Service de Physiologie, Explorations Fonctionnelles, Hôpital Henri Mondor, 51, avenue de Lattre de Tassigny, 94010 Créteil, France.
Neurophysiol Clin. 2004 Oct;34(3-4):141-5. doi: 10.1016/j.neucli.2004.07.003.
Dystonia is associated with excessive corticospinal motor output. Motor cortex excitability may be reduced by low-frequency repetitive transcranial magnetic stimulation (rTMS) of premotor cortical areas. We report the effects of 1 Hz rTMS applied at 90% of resting motor threshold over the left premotor cortex in an open pilot study of three patients with severe, generalized, secondary dystonia including painful spasms in the proximal and axial musculature. A 20-min session of premotor rTMS was daily performed during 5 consecutive days. The series of rTMS sessions dramatically reduced the painful spasms, for 3-8 days after the last session, without any other significant beneficial effects. However, a slight reduction of the Movement score of the Burke, Fahn and Marsden rating scale was observed for two patients, and of the Disability score for the third one. Low-frequency rTMS of the premotor cortex may improve some specific motor symptoms in severe, generalized dystonia. These results should prompt confirmation in a larger placebo-controlled study.
肌张力障碍与皮质脊髓运动输出过多有关。通过对运动前皮质区域进行低频重复经颅磁刺激（rTMS），运动皮质兴奋性可能会降低。在一项针对三名患有严重、全身性、继发性肌张力障碍（包括近端和轴性肌肉组织疼痛性痉挛）患者的开放性初步研究中，我们报告了在左侧运动前皮质以静息运动阈值的90%施加1赫兹rTMS的效果。连续5天每天进行一次为期20分钟的运动前rTMS治疗。一系列rTMS治疗显著减轻了疼痛性痉挛，在最后一次治疗后3至8天内有效，且无任何其他显著有益效果。然而，两名患者的伯克、法恩和马斯登评分量表的运动评分略有降低，第三名患者的残疾评分有所降低。运动前皮质的低频rTMS可能会改善严重全身性肌张力障碍的一些特定运动症状。这些结果应在更大规模的安慰剂对照研究中得到证实。
