Department of Physical Therapy, Daegu University, Gyeongsan, Daegu, Republic of Korea.
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 317-1 Daemyungdong, Namgu, Daegu, 705-717, Republic of Korea.
Brain Stimul. 2017 Mar-Apr;10(2):270-274. doi: 10.1016/j.brs.2016.10.010. Epub 2016 Oct 18.
Half of all stroke patients experience depression, which adversely affects functional recovery. To improve functional outcomes, post-stroke depressive symptoms require more effective management strategies.
This study examined whether repetitive transcranial magnetic stimulation (rTMS) applied over the left dorsolateral prefrontal cortex (DLPFC) can manage post-stroke depression and improve motor function.
This study was a single-center, prospective, double blind, sham-controlled preliminary study. Twenty-four patients with chronic stroke were randomly assigned to two groups: (1) the rTMS group, in which patients received ten sessions of high-frequency (10 Hz) stimulation; and (2) the sham group, in which patients received ten sessions of sham stimulation. Functional recovery was assessed at two time points before the intervention (four weeks and one day) and two time points after the intervention (one day and four weeks), using the Beck Depression Inventory (BDI), 17-item version of the Hamilton Depression Rating Scale (HAM-D17), upper (MI-UE) and lower limb Motricity Indices (MI-LE), modified Brunnstrom Classification (MBC), and Functional Ambulatory Category (FAC) assessments.
At both post-intervention time points, BDI and HAM-D17 in the rTMS group were significantly decreased compared to those in the sham group (Mann-Whitney U test, p < 0.05) and compared to pre-intervention time points (Wilcoxon's test, p < 0.017). However, no significant changes in MI-UE, MI-LE, MBC, and FAC were found.
Our results suggest that rTMS is a beneficial therapeutic modality for managing depression after stroke.
一半的中风患者会经历抑郁，这会对功能恢复产生不利影响。为了改善功能预后，中风后抑郁症状需要更有效的管理策略。
本研究旨在探讨经颅重复磁刺激(rTMS)应用于左背外侧前额叶皮质(DLPFC)是否能治疗中风后抑郁并改善运动功能。
这是一项单中心、前瞻性、双盲、假刺激对照的初步研究。24 例慢性中风患者被随机分为两组：(1)rTMS 组，患者接受 10 次高频(10Hz)刺激；(2)假刺激组，患者接受 10 次假刺激。在干预前的两个时间点(干预前四周一天和干预前一天)和干预后的两个时间点(干预后一天和干预后四周)，使用贝克抑郁量表(BDI)、汉密尔顿抑郁量表 17 项版本(HAM-D17)、上肢运动指数(MI-UE)和下肢运动指数(MI-LE)、改良 Brunnstrom 分级(MBC)和功能性步行分类(FAC)评估进行功能恢复评估。
在干预后的两个时间点，rTMS 组的 BDI 和 HAM-D17 均显著低于假刺激组(曼-惠特尼 U 检验，p<0.05)和干预前时间点(威尔科克森检验，p<0.017)。然而，MI-UE、MI-LE、MBC 和 FAC 没有明显变化。
我们的结果表明，rTMS 是治疗中风后抑郁的一种有益的治疗方法。
