重复经颅磁刺激治疗失语症康复的系统评价：对未来研究的启示。
A systematic review of repetitive transcranial magnetic stimulation in aphasia rehabilitation: Leads for future studies.
机构信息
Handicap Activité Cognition Santé, BPH U1219 Inserm, Université de Bordeaux, F-33000, Bordeaux, France; Institut Universitaire des Sciences de la Réadaptation, Université de Bordeaux, F-33000, Bordeaux, France; Department of physical medicine and rehabilitation, CHU de Bordeaux, F-33000, Bordeaux, France.
Faculté de psychologie, Université de Genève, Geneva, Switzerland.
出版信息
Neurosci Biobehav Rev. 2021 Aug;127:212-241. doi: 10.1016/j.neubiorev.2021.04.008. Epub 2021 Apr 20.
BACKGROUND
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive tool that induces neuromodulation in the brain. Several studies have shown that rTMS improves language recovery in patients with post-stroke aphasia.
OBJECTIVE
This systematic review summarizes the role of rTMS in aphasia rehabilitation.
METHODS
We searched MEDLINE via PubMed and Scopus on 30October, 2020, for English articles (1996-2020). Eligible studies involved post-stroke aphasia rehabilitation with rTMS. In some of these studies, rTMS was also combined with speech therapy.
RESULTS
In total, seven meta-analyses and 59studies (23randomized clinical trials) were included in this systematic review. The methods used in these studies were heterogeneous. Only six studies did not find that rTMS had a significant effect on language performance.
CONCLUSIONS
The evidence from the peer-reviewed literature suggests that rTMS is an effective tool in post-stroke aphasia rehabilitation. However, the precise mechanisms that underlie the effects of rTMS and the reorganization of language networks in patients who have had a stroke remain unclear. We discuss these crucial challenges in the context of future studies.
背景
重复经颅磁刺激（rTMS）是一种非侵入性工具，可在大脑中诱导神经调节。多项研究表明，rTMS 可改善脑卒中后失语症患者的语言恢复。
目的
本系统综述总结了 rTMS 在失语症康复中的作用。
方法
我们于 2020 年 10 月 30 日通过 PubMed 和 Scopus 检索了 MEDLINE 上的英文文章（1996 年至 2020 年）。符合条件的研究涉及使用 rTMS 进行脑卒中后失语症康复，其中一些研究还将 rTMS 与言语治疗相结合。
结果
本系统综述共纳入了 7 项荟萃分析和 59 项研究（23 项随机临床试验）。这些研究采用的方法存在异质性。只有 6 项研究未发现 rTMS 对语言表现有显著影响。
结论
来自同行评议文献的证据表明，rTMS 是脑卒中后失语症康复的有效工具。然而，rTMS 作用的确切机制以及脑卒中患者语言网络的重组仍不清楚。我们在未来研究的背景下讨论了这些关键挑战。
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