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重复经颅磁刺激对植物状态患者意识障碍的临床疗效

The Clinical Effect of Repetitive Transcranial Magnetic Stimulation on the Disturbance of Consciousness in Patients in a Vegetative State.

作者信息

Zhang Xiao-Hua, Han Ping, Zeng Yuan-Yuan, Wang Yu-Long, Lv Hui-Lan

机构信息

Department of Rehabilitation, Shenzhen Dapeng New District Nanao People's Hospital, Shenzhen, China.

Department of Rehabilitation, The First Affiliated Hospital, Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.

出版信息

Front Neurosci. 2021 Apr 30;15:647517. doi: 10.3389/fnins.2021.647517. eCollection 2021.

Abstract

OBJECTIVE

To explore the effect of combining repetitive transcranial magnetic stimulation (rTMS) and conventional rehabilitation on the recovery of consciousness in patients in a persistent vegetative state (PVS).

METHODS

A total of 48 patients in a PVS were randomly divided into a treatment and control group. Patients in the treatment group were treated with rTMS to stimulate the dorsolateral prefrontal cortex, and patients in the control group were treated with false stimulation. All patients were evaluated using scales and neuroelectrophysiological assessment before treatment, after 30 days of treatment, and following 60 days of treatment.

RESULTS

Based on the Coma Recovery Scale-Revised (CRS-R) and electroencephalogram (EEG) grading indexes, the treatment group was significantly higher than those of the control group after 30 and 60 days of treatment. The average difference in the three measurements between the two groups before treatment, at 30 days, and 60 days was 0.04, 1.54, and 2.09 for CRS-R and 0.08, -0.83, and -0.62 for EEG indexes, respectively. The latency periods of each wave of the brainstem auditory evoked potentials (BAEPs) in the treatment group were shorter than those in the control group after 30 and 60 days of treatment. In both groups, the BAEP scores after 30 days of treatment were significantly higher than the scores before treatment, and the scores after 60 days of treatment were higher than the scores after 30 days.

CONCLUSION

In patients in a PVS, rTMS assists in the recovery of consciousness function.

摘要

目的

探讨重复经颅磁刺激(rTMS)联合传统康复治疗对持续性植物状态(PVS)患者意识恢复的影响。

方法

将48例PVS患者随机分为治疗组和对照组。治疗组患者采用rTMS刺激背外侧前额叶皮质,对照组患者采用伪刺激。所有患者在治疗前、治疗30天后和治疗60天后均使用量表和神经电生理评估进行评估。

结果

根据昏迷恢复量表修订版(CRS-R)和脑电图(EEG)分级指标,治疗组在治疗30天和60天后明显高于对照组。两组在治疗前、30天和60天这三个测量时间点的CRS-R平均差异分别为0.04、1.54和2.09,EEG指标的平均差异分别为0.08、-0.83和-0.62。治疗组在治疗30天和60天后脑干听觉诱发电位(BAEP)各波的潜伏期均短于对照组。两组在治疗30天后的BAEP评分均显著高于治疗前,治疗60天后的评分高于治疗30天后。

结论

在PVS患者中,rTMS有助于意识功能的恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98df/8119637/98824b359f1e/fnins-15-647517-g001.jpg

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