Shehata Hatem S, Shalaby Nevin M, Esmail Eman H, Fahmy Ebtesam
Neurology Department, Faculty of Medicine, Cairo University, Giza, Egypt.
Neurol Sci. 2015 Sep;36(9):1651-7. doi: 10.1007/s10072-015-2226-x. Epub 2015 Apr 28.
Corticobasal syndrome (CBS) is a sporadic tauopathy that manifests by a various combination of motor and cognitive deficits, which makes its diagnosis challenging. Treatment of CBS is symptomatic and based on evidence from other similar disorders due to the lack of studies on CBS. The aim of the study was to investigate low-frequency repetitive transcranial magnetic stimulation (rTMS) as a therapeutic tool in CBS. Twenty-six patients with clinically evident CBS according to Cambridge criteria were followed for 12-18 months while receiving low-frequency rTMS combined with pharmacological, rehabilitation treatment and botulinum toxin injection. The majority of patients are manifested with akinetic-rigid syndrome and cognitive dysfunction. There was improvement of the UPDRS and quality of life after 3 months of therapeutic interventions (P < 0.001 and <0.05, respectively). No significant deterioration in cognitive functions was detected over the study period. There was a significant reduction of caregiver burden after 3 months of interventions (P < 0.01); this improvement was maintained up to 18 months. Cognitive dysfunction is a frequent manifestation of CBS. CBS patients can benefit from multidisciplinary therapeutic approach employing low-frequency rTMS.
皮质基底节综合征（CBS）是一种散发性tau蛋白病，表现为运动和认知缺陷的多种组合，这使得其诊断具有挑战性。由于缺乏关于CBS的研究，CBS的治疗是对症治疗，基于其他类似疾病的证据。本研究的目的是探讨低频重复经颅磁刺激（rTMS）作为CBS的一种治疗工具。根据剑桥标准，对26例临床诊断明确的CBS患者进行了12至18个月的随访，期间患者接受低频rTMS治疗，并结合药物治疗、康复治疗和肉毒杆菌毒素注射。大多数患者表现为运动不能-强直综合征和认知功能障碍。治疗干预3个月后，统一帕金森病评定量表（UPDRS）评分和生活质量均有所改善（分别为P < 0.001和<0.05）。在研究期间未检测到认知功能的显著恶化。干预3个月后，照料者负担显著减轻（P < 0.01）；这种改善持续到18个月。认知功能障碍是CBS的常见表现。CBS患者可受益于采用低频rTMS的多学科治疗方法。
