Marzbani H, Shahrokhi A, Irani A, Mehdinezhad M, Kohanpour M, Mirbagheri M M
Annu Int Conf IEEE Eng Med Biol Soc. 2018 Jul;2018:2491-2494. doi: 10.1109/EMBC.2018.8512866.
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive treatment technique for recovery of movement disorders by altering cortical plasticity. In this research, we studied the effects of low-frequency rTMS on white matter (WM) structural connectivity and clinical parameters in children with cerebral palsy (CP).,Four spastic hemiplegic CP children were randomly divided into experimental and control groups. In the experimental group, at first, 1Hz rTMS treatment was performed 4 days/week for 3 weeks on two hemiplegia patients over a contralesional primary motor cortex (M1). Then, 1Hz rTMS treatment was performed 4 days/week for 3 weeks followed by a 30min occupational therapy (OT). In the control group, two CP children received sham rTMS for 3 weeks and then sham rTMS combined with OT for 3 weeks in the same schedule as the experimental group. Evaluations performed using diffusion tensor imaging (DTI), and clinical measurements of gait performance before and after the treatment. Graph theoretical analysis was used to characterize topological changes of structural connectivity. Our findings demonstrate the 1Hz rTMS is effective in improving motor activity in spastic hemiplegic CP children, and is more effective when combined with OT.
重复经颅磁刺激（rTMS）是一种通过改变皮质可塑性来恢复运动障碍的非侵入性治疗技术。在本研究中，我们研究了低频rTMS对脑瘫（CP）儿童白质（WM）结构连通性和临床参数的影响。4名痉挛性偏瘫型CP儿童被随机分为实验组和对照组。在实验组中，首先，对两名偏瘫患者的对侧初级运动皮层（M1）进行1Hz rTMS治疗，每周4天，共3周。然后，进行1Hz rTMS治疗，每周4天，共3周，随后进行30分钟的职业治疗（OT）。在对照组中，两名CP儿童接受假rTMS治疗3周，然后按照与实验组相同的时间表接受假rTMS联合OT治疗3周。使用扩散张量成像（DTI）进行评估，并在治疗前后对步态表现进行临床测量。采用图论分析来表征结构连通性的拓扑变化。我们的研究结果表明，1Hz rTMS对改善痉挛性偏瘫型CP儿童的运动活动有效，并且与OT联合使用时效果更佳。
