Dipartimento di Neuroscienze, Clinica Neurologica, Università Tor Vergata, Via Montpellier 1, 00133 Rome, Italy.
J Neurol. 2011 Jul;258(7):1281-7. doi: 10.1007/s00415-011-5924-1. Epub 2011 Feb 1.
Exercise therapy (ET) can be beneficial in disabled multiple sclerosis (MS) patients. Intermittent transcranial magnetic theta burst stimulation (iTBS) induces long-term excitability changes of the cerebral cortex and may ameliorate spasticity in MS. We investigated whether the combination of iTBS and a program of ET can improve motor disability in MS patients. In a double-blind, sham-controlled trial, 30 participants were randomized to three different interventions: iTBS plus ET, sham stimulation plus ET, and iTBS alone. Before and after 2 weeks of treatment, measures of spasticity through the modified Ashworth scale (MAS) and the 88 items Multiple Sclerosis Spasticity Score questionnaire (MSSS-88), fatigue through the Fatigue Severity Scale (FSS), daily living activities (ADL) through the Barthel index and health-related quality of life (HRQoL) through the 54 items Multiple Sclerosis Quality of life inventory (MSQoL-54) were collected. iTBS plus ET reduced MAS, MSSS-88, FSS scores, while in the Barthel index and MSQoL-54, physical composite scores were increased. iTBS alone caused a reduction of the MAS score, while none of the measured scales showed significant changes after sham iTBS plus ET. iTBS associated with ET is a promising tool for motor rehabilitation of MS patients.
运动疗法（ET）对残疾多发性硬化症（MS）患者有益。间歇性经颅磁 theta 爆发刺激（iTBS）可诱导大脑皮层的长期兴奋性变化，并可能改善 MS 的痉挛。我们研究了 iTBS 与 ET 方案的结合是否可以改善 MS 患者的运动障碍。在一项双盲、假刺激对照试验中，30 名参与者被随机分为三组不同的干预措施：iTBS 加 ET、假刺激加 ET 和 iTBS 单独治疗。在治疗前和治疗 2 周后，通过改良 Ashworth 量表（MAS）和 88 项多发性硬化痉挛评分问卷（MSSS-88）评估痉挛程度，通过疲劳严重程度量表（FSS）评估疲劳程度，通过巴氏指数评估日常生活活动（ADL），通过 54 项多发性硬化生活质量量表（MSQoL-54）评估健康相关生活质量（HRQoL）。iTBS 加 ET 可降低 MAS、MSSS-88 和 FSS 评分，而巴氏指数和 MSQoL-54 的生理综合评分增加。iTBS 单独治疗可降低 MAS 评分，而假刺激加 ET 后，所有测量量表均无明显变化。iTBS 联合 ET 是 MS 患者运动康复的一种有前途的工具。
