重复经颅磁刺激运动皮层可改善多发性硬化症中的痉挛状态。

Repetitive transcranial magnetic stimulation of the motor cortex ameliorates spasticity in multiple sclerosis.

作者信息

Centonze D, Koch G, Versace V, Mori F, Rossi S, Brusa L, Grossi K, Torelli F, Prosperetti C, Cervellino A, Marfia G A, Stanzione P, Marciani M G, Boffa L, Bernardi G

机构信息

Clinica Neurologica, Dipartimento di Neuroscienze, Università di Tor Vergata, Rome, Italy.

出版信息

Neurology. 2007 Mar 27;68(13):1045-50. doi: 10.1212/01.wnl.0000257818.16952.62.

DOI:10.1212/01.wnl.0000257818.16952.62

PMID:17389310

Abstract

OBJECTIVE

To investigate whether repetitive transcranial magnetic stimulation (rTMS) can modify spasticity.

METHODS

We used high-frequency (5 Hz) and low-frequency (1 Hz) rTMS protocols in 19 remitting patients with relapsing-remitting multiple sclerosis and lower limb spasticity.

RESULTS

A single session of 1 Hz rTMS over the leg primary motor cortex increased H/M amplitude ratio of the soleus H reflex, a reliable neurophysiologic measure of stretch reflex. Five hertz rTMS decreased H/M amplitude ratio of the soleus H reflex and increased corticospinal excitability. Single sessions did not induce any effect on spasticity. A significant improvement of lower limb spasticity was observed when rTMS applications were repeated during a 2-week period. Clinical improvement was long-lasting (at least 7 days after the end of treatment) when the patients underwent 5 Hz rTMS treatment during a 2-week protocol. No effect was obtained after a 2-week sham stimulation.

CONCLUSIONS

Repetitive transcranial magnetic stimulation may improve spasticity in multiple sclerosis.

摘要

目的

研究重复经颅磁刺激（rTMS）是否能改善痉挛状态。

方法

我们对19例缓解期复发缓解型多发性硬化症且伴有下肢痉挛的患者采用高频（5Hz）和低频（1Hz）rTMS方案。

结果

对腿部初级运动皮层进行单次1Hz的rTMS可增加比目鱼肌H反射的H/M波幅比值，这是一种可靠的牵张反射神经生理学测量指标。5Hz的rTMS降低了比目鱼肌H反射的H/M波幅比值，并增加了皮质脊髓兴奋性。单次刺激对痉挛状态未产生任何影响。当在2周内重复进行rTMS治疗时，观察到下肢痉挛状态有显著改善。当患者在为期2周的方案中接受5Hz的rTMS治疗时，临床改善效果持久（治疗结束后至少持续7天）。经过2周的假刺激后未观察到效果。