不同频率重复经颅磁刺激（rTMS）对脑梗死吞咽障碍患者的影响。
The effects of different frequencies of repetitive transcranial magnetic stimulation (rTMS) on patients with swallowing disorders after cerebral infarction.
机构信息
Department of Rehabilitation, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
State Key Laboratory of Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
出版信息
NeuroRehabilitation. 2022;50(1):115-122. doi: 10.3233/NRE-210176.
BACKGROUND
Swallowing disorders represent one of the most common complications after cerebral infarction.
OBJECTIVE
To study the effects of different frequencies of repetitive transcranial magnetic stimulation (rTMS) on swallowing disorders after cerebral infarction.
METHODS
Ninety patients with swallowing disorder after cerebral infarction were enrolled and randomly assigned to three groups: the 10 Hz frequency rTMS group (30 patients), the 5 Hz frequency rTMS group (30 patients), and the 1 Hz frequency rTMS group (30 patients); another 90 healthy persons without swallowing disorders were included as the control group. The Kubota's water-swallow test, the video fluoroscopic swallow study (VFSS), and the Electroencephalograph (EEG) were analyzed before and after treatment; the EEG of the control group was detected as the baseline.
RESULTS
The Kubota's water-swallow test scores were significantly decreased while the scores of pharynx period and the aspiration degree of VFSS significantly increased in 10 Hz frequency rTMS group than before treatment (P≤0.05); the amplitudes of C3 of the EEG significantly increased in three frequency groups than before treatment (P≤0.05).
CONCLUSIONS
10 Hz frequency of rTMS is effective for the treatment of swallowing disorder after cerebral infarction, the excitement of C3 area maybe the therapeutic target of rTMS on swallowing disorder after cerebral infarction.
背景
吞咽障碍是脑梗死后最常见的并发症之一。
目的
研究不同频率重复经颅磁刺激（rTMS）对脑梗死后吞咽障碍的影响。
方法
将 90 例脑梗死后吞咽障碍患者随机分为 3 组，10 Hz 频率 rTMS 组（30 例）、5 Hz 频率 rTMS 组（30 例）和 1 Hz 频率 rTMS 组（30 例），另选取 90 例无吞咽障碍的健康者作为对照组。治疗前后分别采用 Kubota 饮水试验、视频荧光吞咽造影检查（VFSS）和脑电图（EEG）分析；对照组的 EEG 作为基线进行检测。
结果
10 Hz 频率 rTMS 组治疗后 Kubota 饮水试验评分明显降低，VFSS 咽期和吸入程度评分明显升高（P≤0.05）；三组 rTMS 治疗后 EEG 的 C3 波幅明显增加（P≤0.05）。
结论
10 Hz 频率 rTMS 治疗脑梗死后吞咽障碍有效，C3 区兴奋可能是 rTMS 治疗脑梗死后吞咽障碍的治疗靶点。
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