Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital,166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea. E-mail:
J Rehabil Med. 2014 May;46(5):418-23. doi: 10.2340/16501977-1802.
To investigate the safety, feasibility and preliminary efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) over the cerebellum in ataxic patients with acute posterior circulation stroke.
Randomized, double-blind, sham-controlled pilot study.
Thirty-two ataxic patients with posterior circulation stroke were randomized to real (n = 22) and sham (n = 10) rTMS groups.
Patients received 5 15-min sessions of 1 Hz cerebellar rTMS over 5 consecutive days. Compliance and adverse events for the rTMS sessions were checked. The 10-m walk test (10MWT) and Berg Balance Scale (BBS) were completed before rTMS, immediately and 1 month after the last rTMS session.
Compliance with the rTMS was 100% and no adverse events were reported in either group. 10MWT and BBS of real rTMS group improved significantly (p < 0.01). Percentage changes immediately after the last rTMS session for time and steps in the 10MWT and BBS in the real vs sham group were: -16.7 ± 35.1% vs -8.4 ± 72.5%, -8.5 ± 23.0% vs -0.3 ± 28.4% and 46.4 ± 100.2% vs 36.6 ± 71.6%, respectively.
This study demonstrated that 1 Hz rTMS over the cerebellum is safe, feasible and may have a beneficial effect in ataxic patients with posterior circulation stroke.
研究小脑低频重复经颅磁刺激（rTMS）治疗急性后循环卒中后共济失调患者的安全性、可行性和初步疗效。
随机、双盲、假刺激对照的初步研究。
32 例后循环卒中后共济失调患者随机分为真刺激（n=22）和假刺激（n=10）rTMS 组。
患者接受 5 次 1 Hz 小脑 rTMS 治疗，每次 15 分钟，连续 5 天。检查 rTMS 治疗期间的依从性和不良事件。在 rTMS 治疗前、治疗后即刻和最后一次 rTMS 治疗后 1 个月，分别进行 10 米步行试验（10MWT）和 Berg 平衡量表（BBS）评估。
rTMS 治疗的依从性为 100%，两组均未报告不良事件。真刺激 rTMS 组的 10MWT 和 BBS 显著改善（p<0.01）。治疗后即刻，真刺激组与假刺激组的 10MWT 时间和步数以及 BBS 的百分比变化分别为：-16.7±35.1%比-8.4±72.5%，-8.5±23.0%比-0.3±28.4%和 46.4±100.2%比 36.6±71.6%。
本研究表明，小脑 1 Hz rTMS 治疗安全、可行，可能对后循环卒中后共济失调患者有益。
