慢性卒中患者高频经颅磁刺激的安全性研究。
Safety study of high-frequency transcranial magnetic stimulation in patients with chronic stroke.
作者信息
Lomarev M P, Kim D Y, Richardson S Pirio, Voller B, Hallett M
机构信息
Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, NIH Building 10, Room 5N240, 10 Center Dr MSC 1428, Bethesda, MD 20892-1428, USA.
出版信息
Clin Neurophysiol. 2007 Sep;118(9):2072-5. doi: 10.1016/j.clinph.2007.06.016. Epub 2007 Jul 24.
OBJECTIVE
Repetitive transcranial magnetic stimulation (rTMS) is a potential therapeutic tool to rehabilitate chronic stroke patients. In this study, the safety of high-frequency rTMS in stroke was investigated (Phase I).
METHODS
The safety of 20 and 25 Hz rTMS over the motor cortex (MC) of the affected hemisphere, with intensities of 110-130% of the motor threshold (MT), was evaluated using surface electromyography (EMG) of hand and arm muscles.
RESULTS
Brief EMG bursts, possibly representing peripheral manifestations of after discharges, and spread of excitation to proximal muscles are considered to be associated with a high risk of seizure occurrence. These events were recorded after the rTMS trains. Neither increased MC excitability nor improved pinch force dynamometry was found after rTMS.
CONCLUSIONS
Stimulation parameters for rTMS, which are safe for healthy volunteers, may lead to a higher risk for seizure occurrence in chronic stroke patients.
SIGNIFICANCE
rTMS at rates of 20 and 25 Hz using above threshold stimulation potentially increases the risk of seizures in patients with chronic stroke.
目的
重复经颅磁刺激（rTMS）是一种用于慢性中风患者康复的潜在治疗工具。在本研究中，对高频rTMS在中风患者中的安全性进行了调查（I期）。
方法
使用手部和手臂肌肉的表面肌电图（EMG）评估在受影响半球的运动皮层（MC）上施加20Hz和25Hz的rTMS，强度为运动阈值（MT）的110 - 130%时的安全性。
结果
短暂的EMG爆发，可能代表放电后的外周表现，以及兴奋扩散到近端肌肉，被认为与癫痫发作的高风险相关。这些事件在rTMS序列后被记录到。rTMS后未发现运动皮层兴奋性增加或捏力测力计测量结果改善。
结论
对健康志愿者安全的rTMS刺激参数，可能会使慢性中风患者癫痫发作的风险更高。
意义
使用高于阈值的刺激频率为20Hz和25Hz的rTMS可能会增加慢性中风患者癫痫发作的风险。
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