Ge Xin, Zhang Yue, Xin Tian, Luan Xue
Department of Neurosurgery and Coma Recovery, Central Hospital of Jinzhou, Jinzhou, Liaoning 121001, P.R. China.
Department of ICU and Coma Recovery, Wuxi 9th Affiliated Hospital of Soochow University, 999 Liangxi Road, Jinzhou, Liaoning 214000, P.R. China.
Exp Ther Med. 2021 Mar;21(3):206. doi: 10.3892/etm.2021.9626. Epub 2021 Jan 13.
The aim of the present study was to investigate the effects of 10 Hz repetitive transcranial magnetic stimulation (rTMS) of the right dorsolateral prefrontal cortex (DLPFC) during vegetative state (VS). Between May 2017 and November 2018, 95 patients were treated in the Coma Recovery Department of the Central Hospital of Jinzhou. According to the inclusion and exclusion criteria, a total of 32 patients in VS caused by brain injury were enrolled. The patients were assigned into rTMS and control groups in a non-randomized manner. All patients received JFK Coma Recovery Scale-Revised (CRS-R) scores and underwent motor evoked potential (MEP) latency and central motor conduction time (CMCT) measurement before the first treatment and after 20 days of treatment, which was the end of the study. Following 20 days of treatment, a significant increase was observed in the CRS-R scores of patients in the rTMS group compared with those obtained at pretreatment (P<0.001). An increase in the CRS-R scores of the control group was also observed compared with the pretreatment scores (P=0.035). The change in CRS-R scores (P<0.001) and improved conscious state rate (P=0.0016) were significantly different between the two groups. A significant decrease in MEP (P<0.001) and CMCT (P<0.001) was observed in the rTMS group compared with measurements obtained at pretreatment, whereas no significant decrease was observed in the control group (P=0.693; P=0.070). The changes in MEP (P<0.001) and CMCT (P<0.001) between the two groups were statistically significant. In conclusion, 10 Hz rTMS of the right DLPFC in early disorders of consciousness is feasible and efficient. rTMS treatment could improve patient state of awareness and accelerate patient recovery in VS.
本研究的目的是探讨在植物状态（VS）期间对右侧背外侧前额叶皮质（DLPFC）进行10赫兹重复经颅磁刺激（rTMS）的效果。2017年5月至2018年11月期间，95例患者在锦州中心医院昏迷康复科接受治疗。根据纳入和排除标准，共纳入32例因脑损伤导致VS的患者。患者以非随机方式分为rTMS组和对照组。所有患者在首次治疗前和治疗20天（即研究结束时）接受了JFK昏迷恢复量表修订版（CRS-R）评分，并进行了运动诱发电位（MEP）潜伏期和中枢运动传导时间（CMCT）测量。治疗20天后，与治疗前相比，rTMS组患者的CRS-R评分显著增加（P<0.001）。与治疗前评分相比，对照组的CRS-R评分也有所增加（P=0.035）。两组之间CRS-R评分的变化（P<0.001）和意识状态改善率（P=0.0016）存在显著差异。与治疗前测量结果相比，rTMS组的MEP（P<0.001）和CMCT（P<0.001）显著降低，而对照组未观察到显著降低（P=0.693；P=0.070）。两组之间MEP（P<0.001）和CMCT（P<0.001）的变化具有统计学意义。总之，在意识障碍早期对右侧DLPFC进行10赫兹rTMS是可行且有效的。rTMS治疗可改善VS患者的意识状态并加速患者康复。
