小脑 rTMS 治疗进行性核上性麻痹的运动控制。
Cerebellar rTMS for motor control in progressive supranuclear palsy.
机构信息
Murray Center for Research on Parkinson's & Related Disorders, Department of Neurology, Medical University of South Carolina, Charleston, SC, USA.
Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA.
出版信息
Brain Stimul. 2019 Nov-Dec;12(6):1588-1591. doi: 10.1016/j.brs.2019.07.017. Epub 2019 Jul 25.
BACKGROUND
Stimulatory cerebellar TMS is a promising tool to improve motor control in neurodegenerative disorders.
OBJECTIVE/HYPOTHESIS: Our goal was to use 10Hz cerebellar rTMS to augment cerebellar-brain inhibition (CBI) for improved postural stability and speech in patients with progressive supranuclear palsy (PSP).
METHODS
We performed CBI assessments with neuronavigation before and after high frequency cerebellar rTMS or sham TMS in two patients with PSP, using a double cone coil for the conditioning pulse and a figure-of-eight coil for the test pulse and treatments. We collected posturography data and speech samples before and after treatment.
RESULTS
After treatment, CBI increased by 50% in subject 1 and by 32% in subject 2, and postural stability and speech improved. The protocol was well tolerated, but the sham was not consistently believable.
CONCLUSION
Cerebellar rTMS may improve postural stability and speech in PSP, but cooled coils with vibrotactile sham capability are needed for larger future studies.
背景
刺激小脑 TMS 是一种很有前途的工具，可以改善神经退行性疾病中的运动控制。
目的/假设：我们的目标是使用 10Hz 小脑 rTMS 来增强小脑-大脑抑制（CBI），以提高进行性核上性麻痹（PSP）患者的姿势稳定性和言语能力。
方法
我们在两名 PSP 患者中使用双锥线圈进行条件脉冲和 8 字形线圈进行测试脉冲和治疗，在高频小脑 rTMS 或假 TMS 前后使用神经导航进行 CBI 评估。我们在治疗前后收集了姿势描记术数据和语音样本。
结果
治疗后，受试者 1 的 CBI 增加了 50%，受试者 2 的 CBI 增加了 32%，姿势稳定性和言语能力都有所改善。该方案耐受性良好，但假刺激并不总是可信。
结论
小脑 rTMS 可能改善 PSP 患者的姿势稳定性和言语能力，但需要使用带有振动假刺激功能的冷却线圈进行更大规模的未来研究。
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