Ye Lin-Lin, Xie Huan-Xin, Cao Lei, Song Wei-Qun
Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2022 Jan 24;12:799058. doi: 10.3389/fneur.2021.799058. eCollection 2021.
This study aimed to investigate changes in attention processing after low-frequency repetitive transcranial magnetic stimulation (rTMS) over the left posterior parietal cortex to better understand its role in visuospatial neglect (VSN) rehabilitation. The current study included 10 subacute stroke patients with VSN consecutively recruited from the inpatient stroke rehabilitation center at Xuanwu Hospital (the teaching hospital affiliated with Capital Medical University) between March and November 2019. All patients performed a battery of tasks (including line bisection, line cancellation, and star cancellation tests) two weeks before treatment and at the beginning and end of treatment; the attentive components of the test results were analyzed. In addition, low-frequency rTMS was used to stimulate the left posterior parietal cortex for 14 days and event-related potential data were collected before and after the stimulation. Participants were evaluated using a target-cue paradigm and pencil-paper tests. No significant differences were detected on the battery of tasks before rTMS. However, we found that rTMS treatment significantly improved the response times and accuracy rates of patients with VSN. After rTMS, the treatment side (left) amplitude of P300 following an event-related potential was higher than that before treatment (left target, = 0.002; right target, = 0.047). Thus, our findings suggest that rTMS may be an effective treatment for VSN. The observed increase in event-related potential amplitude supports the hypothesized compensational role of the contralesional hemisphere in terms of residual performance. Our results provide electrophysiological evidence that may help determine the mechanisms mediating the therapeutic effects of rTMS.
本研究旨在探讨经颅磁刺激（rTMS）低频刺激左侧顶叶后皮质后注意力处理的变化，以更好地理解其在视觉空间忽视（VSN）康复中的作用。本研究连续纳入了10例患有VSN的亚急性卒中患者，这些患者于2019年3月至11月期间从宣武医院（首都医科大学附属教学医院）的住院卒中康复中心招募。所有患者在治疗前两周以及治疗开始时和结束时均进行了一系列任务（包括直线二等分、直线划消和星形划消测试）；对测试结果的注意力成分进行了分析。此外，使用低频rTMS刺激左侧顶叶后皮质14天，并在刺激前后收集事件相关电位数据。采用目标-线索范式和纸笔测试对参与者进行评估。在rTMS之前的一系列任务中未检测到显著差异。然而，我们发现rTMS治疗显著改善了VSN患者的反应时间和准确率。rTMS后，事件相关电位后P300的治疗侧（左侧）波幅高于治疗前（左侧目标， = 0.002；右侧目标， = 0.047）。因此，我们的研究结果表明rTMS可能是治疗VSN的有效方法。观察到的事件相关电位波幅增加支持了对侧半球在残余表现方面的假设补偿作用。我们的结果提供了电生理证据，可能有助于确定介导rTMS治疗效果的机制。
