Choi Hana, Seo Kyung Cheon, Kim Tae Uk, Lee Seong Jae, Hyun Jung Keun
Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea.
Department of Nanobiomedical Science and BK21 Plus NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan, Korea.
Ann Rehabil Med. 2019 Feb;43(1):62-73. doi: 10.5535/arm.2019.43.1.62. Epub 2019 Feb 28.
To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on neurological and functional recovery in patients with central cord syndrome (CCS) involving the upper extremities between the treated and non-treated sides of the treated group and whether the outcomes are comparable to that of the untreated control group.
Nineteen CCS patients were treated with high-frequency (20 Hz) rTMS over the motor cortex for 5 days. The stimulation side was randomly selected, and all the subjects received conventional occupational therapy during the rTMS-treatment period. Twenty CCS patients who did not receive rTMS were considered as controls. Clinical assessments, including those by the International Standard for Neurological Classification of Spinal Cord Injury, the Jebsen-Taylor Hand Function Test, and the O'Connor Finger Dexterity Test were performed initially and followed up for 1 month after rTMS treatment or 5 weeks after initial assessments.
The motor scores for upper extremities were increased and the number of improved cases was greater for the treated side in rTMS-treated patients than for the non-treated side in rTMS-treated patients or controls. The improved cases for writing time and score measured on the Jebsen-Taylor Hand Function Test were also significantly greater in number on the rTMS-treated side compared with the non-treated side and controls. There were no adverse effects during rTMS therapy or the follow-up period.
The results of the application of high-frequency rTMS treatment to CCS patients suggest that rTMS can enhance the motor recovery and functional fine motor task performance of the upper extremities in such individuals.
探讨重复经颅磁刺激(rTMS)对上肢受累的中央脊髓综合征(CCS)患者治疗组治疗侧与未治疗侧神经功能及功能恢复的影响,以及结果是否与未治疗的对照组相当。
19例CCS患者在运动皮层接受高频(20Hz)rTMS治疗5天。刺激侧随机选择,所有受试者在rTMS治疗期间接受常规职业治疗。20例未接受rTMS的CCS患者作为对照。最初进行临床评估,包括脊髓损伤神经学分类国际标准、杰布森 - 泰勒手功能测试和奥康纳手指灵活性测试,在rTMS治疗后1个月或初始评估后5周进行随访。
rTMS治疗患者中,治疗侧上肢运动评分增加,改善病例数多于未治疗侧患者或对照组的未治疗侧。与未治疗侧和对照组相比,rTMS治疗侧在杰布森 - 泰勒手功能测试中测量的书写时间和得分改善病例数也明显更多。rTMS治疗期间及随访期间均无不良反应。
对CCS患者应用高频rTMS治疗的结果表明,rTMS可增强此类患者上肢的运动恢复及精细运动任务表现。