5 天每日θ爆发刺激对肌萎缩侧索硬化症皮质脊髓兴奋性的累积效应。
Cumulative effect of 5 daily sessions of θ burst stimulation on corticospinal excitability in amyotrophic lateral sclerosis.
机构信息
Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology/Clinical Neurophysiology, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
出版信息
Muscle Nerve. 2013 Nov;48(5):733-8. doi: 10.1002/mus.23818. Epub 2013 Aug 30.
INTRODUCTION
Excitotoxicity plays an important role in the pathogenesis of the preferential motor neuron death observed in amyotrophic lateral sclerosis (ALS). Continuous theta burst stimulation (cTBS) by transcranial magnetic stimulation has an inhibitory effect on corticospinal excitability (CSE). We characterized the neurophysiological changes induced by cTBS in ALS.
METHODS
The patients received 5 daily sessions of cTBS. CSE was assessed at baseline and after each session of cTBS.
RESULTS
The amplitude of a single pulse motor evoked potential was significantly decreased (34%) over the days. The amplitude returned to baseline a week after the last session. The resting motor threshold increased significantly, whereas intracortical inhibition and facilitation did not change over the sessions.
CONCLUSIONS
Daily cTBS has a cumulative depressing effect on CSE in patients with ALS. These results suggest that modulation of CSE in ALS is possible, but repetitive sessions are needed to maintain the effect.
简介
兴奋性毒性在肌萎缩侧索硬化症（ALS）中观察到的运动神经元优先死亡的发病机制中起重要作用。经颅磁刺激的连续 theta 爆发刺激（cTBS）对皮质脊髓兴奋性（CSE）具有抑制作用。我们描述了 cTBS 在 ALS 中引起的神经生理变化。
方法
患者接受了 5 天的 cTBS 治疗。在基线和每次 cTBS 治疗后评估 CSE。
结果
单脉冲运动诱发电位的振幅在几天内显著降低（34%）。最后一次治疗一周后，振幅恢复到基线。静息运动阈值显著增加，而皮质内抑制和易化在各次治疗中没有变化。
结论
每日 cTBS 对 ALS 患者的 CSE 具有累积抑制作用。这些结果表明，ALS 中 CSE 的调节是可能的，但需要重复治疗来维持疗效。
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