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中风早期对腿部运动区进行高频重复经颅磁刺激

High-frequency rTMS on leg motor area in the early phase of stroke.

作者信息

Sasaki Nobuyuki, Abo Masahiro, Hara Takatoshi, Yamada Naoki, Niimi Masachika, Kakuda Wataru

机构信息

Department of Rehabilitation Medicine, International University of Health and Welfare Atami Hospital, 13-1, Higashi Kaigan-cho, Atami-Shi, Shizuoka, 413-0012, Japan.

Department of Rehabilitation Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan.

出版信息

Acta Neurol Belg. 2017 Mar;117(1):189-194. doi: 10.1007/s13760-016-0687-1. Epub 2016 Aug 9.

Abstract

Although repetitive transcranial magnetic stimulation (rTMS) for upper limb motor area in stroke patients is beneficial, it has been poorly investigated in rTMS for leg motor area. Furthermore, no study has examined the usefulness of rTMS for leg motor area in patients in the early phase of stroke. Twenty-one patients with a hemispheric stroke lesion in the early phase were randomly assigned into two groups: the high-frequency (HF)-rTMS group [N = 11] and the sham stimulation group [N = 10]. Patients received rTMS for 5 consecutive days, beginning 10.9 ± 6.6 days on average after the onset. Brunnstrom Recovery Stages (BRS) for the lower limbs and the Ability for Basic Movement Scale Revised (ABMS II) were assessed before and after the intervention. The improvement in BRS for the lower limbs was significant after the intervention in the HF-rTMS group. Although both the HF-rTMS and sham stimulation groups had significant improvements in ABMS II scores, the extent of improvement in the AMBS II was significantly greater in the HF-rTMS group than in the sham stimulation group. Application of HF-rTMS over the bilateral leg motor areas has potential to be a new rehabilitation therapy for patients in the acute phase of stroke.

摘要

尽管对中风患者的上肢运动区进行重复经颅磁刺激(rTMS)是有益的,但对腿部运动区进行rTMS的研究却很少。此外,尚无研究探讨rTMS对中风早期患者腿部运动区的有效性。21例处于早期的半球性中风患者被随机分为两组:高频(HF)-rTMS组[N = 11]和假刺激组[N = 10]。患者连续5天接受rTMS治疗,平均在发病后10.9±6.6天开始。在干预前后评估下肢的Brunnstrom恢复阶段(BRS)和修订后的基本运动能力量表(ABMS II)。HF-rTMS组干预后下肢BRS有显著改善。尽管HF-rTMS组和假刺激组的ABMS II评分均有显著改善,但HF-rTMS组的AMBS II改善程度明显大于假刺激组。对双侧腿部运动区应用HF-rTMS有可能成为中风急性期患者的一种新的康复治疗方法。

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