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选择性经颅磁刺激联合功能近红外光谱及强化言语治疗对脑卒中后失语症患者的影响。

The Effect of Selective Transcranial Magnetic Stimulation with Functional Near-Infrared Spectroscopy and Intensive Speech Therapy on Individuals with Post-Stroke Aphasia.

作者信息

Hara Takatoshi, Abo Masahiro, Kakita Kiyohito, Mori Yuko, Yoshida Makoto, Sasaki Nobuyuki

机构信息

Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.

出版信息

Eur Neurol. 2017;77(3-4):186-194. doi: 10.1159/000457901. Epub 2017 Feb 4.

Abstract

PURPOSE

To examine the efficacy of selective repetitive transcranial magnetic stimulation (rTMS) therapy guided by functional near-infrared spectroscopy (fNIRS) combined with intensive speech therapy (iST) on post-stroke patients with aphasia.

MATERIAL AND METHODS

Eight right-handed patients with aphasia in the chronic stage after stroke were grouped into left and right hemisphere-activated for a language task based on pre-intervention fNIRS. Those with left hemisphere activation received 1-Hz TMS to the right inferior frontal gyrus (RtIFG; low-frequency rTMS [LFS] group), and those with right hemisphere activation received 10-Hz TMS to the RtIFG (high-frequency rTMS [HFS] group). The patients underwent an 11-day program of rTMS and iST.

RESULTS

Both groups showed a significant improvement in language function as measured by Standard Language Test of Aphasia (SLTA) total score at post-intervention relative to pre-intervention. Furthermore, the pre-to-post SLTA change scores were not statistically different between the groups. Comparison of pre- and post-intervention fNIRS revealed a resolution of the imbalance of interhemispheric inhibition in the LFS group and activation of the target hemisphere in the HFS group.

CONCLUSIONS

The administration of fNIRS-guided selective rTMS therapy and iST to post-stroke patients with aphasia induced a significant improvement in language function, with both groups demonstrating a similar degree of improvement.

摘要

目的

探讨功能近红外光谱(fNIRS)引导下的选择性重复经颅磁刺激(rTMS)疗法联合强化言语治疗(iST)对脑卒中后失语患者的疗效。

材料与方法

8例脑卒中后慢性期的右利手失语患者,根据干预前fNIRS将其分为左半球激活组和右半球激活组,以进行语言任务。左半球激活的患者接受对右侧额下回(RtIFG)的1Hz经颅磁刺激(低频rTMS [LFS]组),右半球激活的患者接受对RtIFG的10Hz经颅磁刺激(高频rTMS [HFS]组)。患者接受为期11天的rTMS和iST治疗方案。

结果

与干预前相比,两组在干预后通过失语症标准语言测试(SLTA)总分测量的语言功能均有显著改善。此外,两组之间SLTA的前后变化分数无统计学差异。干预前后fNIRS的比较显示,LFS组半球间抑制失衡得到解决,HFS组目标半球被激活。

结论

对脑卒中后失语患者给予fNIRS引导的选择性rTMS疗法和iST可显著改善语言功能,两组改善程度相似。

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