加速重复经颅磁刺激治疗轻度创伤性脑损伤后脑震荡症状的初步研究。
Accelerated repetitive transcranial magnetic stimulation in the treatment of post-concussion symptoms due to mild traumatic brain injury: a pilot study.
机构信息
Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada.
出版信息
Brain Inj. 2021 Jan 5;35(1):48-58. doi: 10.1080/02699052.2020.1857837. Epub 2020 Dec 10.
: To investigate the feasibility, tolerability, and efficacy of twice-daily, low frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the right dorsolateral prefrontal cortex (DLPFC) in the reduction of chronic post-concussion symptoms (PCS) in patients who have suffered a mild traumatic brain injury (mTBI).: 15 patients with mTBI received 30 sessions of twice-daily LF rTMS (1 Hz) over the right DLPFC. Post-concussion symptoms, pain, disability, fatigue, apathy, agitation, and mood were assessed by a psychiatrist pre- and post-treatment. Cognitive testing was also performed pre-, mid-, and post-rTMS.: All participants completed treatment with no serious adverse events. Significant improvements were observed in overall post-concussion symptoms, disability and pain ratings, as well as depression and anxiety symptoms. There was no significant change in overall executive functioning, fatigue severity, apathy, or agitation. Cognitive testing revealed improvements in verbal fluency, working memory, selective attention, and cognitive processing speed.: This small-sample pilot study suggests that twice-daily, LF rTMS over the right DLPFC can be safely and tolerably applied and has the potential to improve post-concussion symptoms as well as elements of mood and cognition in patients with mTBI. Larger, sham-controlled studies will be important to confirm these observations.
: 目的:研究每日两次、低频(LF)重复经颅磁刺激(rTMS)对右背外侧前额叶皮质(DLPFC)在减轻轻度创伤性脑损伤(mTBI)后慢性脑震荡后症状(PCS)的可行性、耐受性和疗效。: 15 名 mTBI 患者接受了 30 次每日两次 LF rTMS(1 Hz)治疗右 DLPFC。在治疗前后,由精神科医生评估脑震荡后症状、疼痛、残疾、疲劳、冷漠、激越和情绪。还进行了认知测试,分别在 rTMS 治疗前、中期和后期进行。: 所有参与者均完成了治疗,无严重不良事件。总体脑震荡后症状、残疾和疼痛评分以及抑郁和焦虑症状均显著改善。总体执行功能、疲劳严重程度、冷漠或激越无显著变化。认知测试显示言语流畅性、工作记忆、选择性注意和认知加工速度有所改善。: 这项小样本初步研究表明,每日两次、右 DLPFC 的 LF rTMS 既安全又耐受,有可能改善 mTBI 患者的脑震荡后症状以及情绪和认知的某些方面。更大规模、假对照研究将有助于证实这些观察结果。