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低频重复经颅磁刺激治疗耐药性部分性癫痫:一项对照临床研究。

Low-frequency repetitive transcranial magnetic stimulation for the treatment of refractory partial epilepsy: a controlled clinical study.

机构信息

Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China.

出版信息

Epilepsia. 2012 Oct;53(10):1782-9. doi: 10.1111/j.1528-1167.2012.03626.x. Epub 2012 Sep 5.

Abstract

PURPOSE

This study was designed to evaluate the therapeutic effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on patients with refractory partial epilepsy.

METHODS

Sixty-four patients with refractory focal epilepsy were screened and 60 patients were randomly divided into two groups by stimulation intensity: 90% (group 1) or 20% (group 2) of resting motor threshold (rMT). Seizure frequency and interictal EEG epileptic discharges were compared between the baseline and follow-up periods.

KEY FINDINGS

Seizures significantly decreased following 2-weeks high intensity (90% rMT) rTMS treatment compared with baseline level (p < 0.05). rTMS also decreased interictal epilepsy discharges and improved the scales of Symptom Checklist-90 significantly (p < 0.05). Seizures and spikes in the follow-up period in the patients who received low intensity (20% rMT) rTMS did not show any difference compared with baseline data (p > 0.05, respectively).

SIGNIFICANCE

Low-frequency high intensity rTMS (90% rMT) delivered into the epileptogenic zone had a significant antiepileptic effect on patients with refractory partial seizures. rTMS treatment can also reduce the interictal epileptic discharge frequency and improve the psychological condition of these patients.

摘要

目的

本研究旨在评估低频重复经颅磁刺激(rTMS)对难治性部分性癫痫患者的治疗效果。

方法

筛选出 64 例难治性局灶性癫痫患者,根据刺激强度将 60 例患者随机分为两组:90%(组 1)或 20%(组 2)静息运动阈值(rMT)。比较基线期和随访期的癫痫发作频率和间脑 EEG 癫痫放电。

主要发现

与基线水平相比,高强度(90% rMT)rTMS 治疗 2 周后癫痫发作明显减少(p < 0.05)。rTMS 还降低了间脑癫痫发作放电,并显著改善了症状清单-90 量表(p < 0.05)。接受低强度(20% rMT)rTMS 的患者在随访期间的癫痫发作和棘波与基线数据相比没有差异(分别为 p > 0.05)。

意义

针对致痫区的低频高强度 rTMS(90% rMT)对难治性部分性癫痫发作患者具有显著的抗癫痫作用。rTMS 治疗还可以降低间脑癫痫放电频率,改善这些患者的心理状况。

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