Fu Mengmeng, Wei Hua, Meng Xianghong, Chen Hai, Shang Baoxiang, Chen Fuyong, Huang Zhaoyang, Sun Ying, Wang Yuping
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, Shenzhen University General Hospital, Shenzhen University, Shenzhen, China.
Front Neurol. 2021 Feb 12;12:602830. doi: 10.3389/fneur.2021.602830. eCollection 2021.
Traditional medical treatments are not effective for some patients with Tourette syndrome (TS). According to the literature, repetitive transcranial magnetic stimulation (rTMS) may be effective for the treatment of TS; however, different targets show different results. To assess the efficacy and safety of low-frequency rTMS in patients with TS, with the bilateral parietal cortex as the target. Thirty patients with TS were divided into two groups: active and sham groups. The active group was subjected to 0.5-Hz rTMS at 90% of resting motor threshold (RMT) with 1,200 stimuli/day/side, whereas the sham group was subjected to 0.5-Hz rTMS at 10% of RMT with 1,200 stimuli/day/side with changes in the coil direction. Both groups were bilaterally stimulated over the parietal cortex (P3 and P4 electrode sites) for 10 consecutive days. The symptoms of tics and premonitory urges were evaluated using the Yale Global Tic Severity Scale (YGTSS), Modified Scoring Method for the Rush Video-based Tic Rating Scale (MRVBTS), and Premonitory Urge for Tics Scale (PUTS) scores at baseline, the end of the 10-day treatment, 1 week after treatment, and 1 month after treatment. At the end of the 10-day treatment, the YGTSS total, YGTSS motor tic, YGTSS phonic tic, MRVBTS, and PUTS scores in the active group significantly improved and improvements were maintained for at least 1 month. Low-frequency bilateral rTMS of the parietal cortex can markedly alleviate motor tics, phonic tics, and premonitory urges in patients with TS.
传统医学治疗方法对一些抽动秽语综合征（TS）患者无效。根据文献，重复经颅磁刺激（rTMS）可能对TS的治疗有效；然而，不同的靶点显示出不同的结果。为了评估以双侧顶叶皮质为靶点的低频rTMS治疗TS患者的疗效和安全性。30例TS患者被分为两组：治疗组和假刺激组。治疗组接受频率为0.5Hz、强度为静息运动阈值（RMT）90%的rTMS，每天每侧给予1200次刺激，而假刺激组接受频率为0.5Hz、强度为RMT 10%的rTMS，每天每侧给予1200次刺激，同时改变线圈方向。两组均在顶叶皮质（P3和P4电极部位）进行双侧刺激，连续10天。使用耶鲁综合抽动严重程度量表（YGTSS）、基于拉什视频的抽动评定量表改良评分方法（MRVBTS）和抽动预兆量表（PUTS）在基线、10天治疗结束时、治疗后1周和治疗后1个月对抽动和预兆性冲动症状进行评估。在10天治疗结束时，治疗组的YGTSS总分、YGTSS运动性抽动、YGTSS发声性抽动、MRVBTS和PUTS评分显著改善，且改善至少维持1个月。顶叶皮质低频双侧rTMS可显著减轻TS患者的运动性抽动、发声性抽动和预兆性冲动。
