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低频(0.5Hz)和高频(10Hz)重复经颅磁刺激对缺血性脑卒中患者神经功能、运动功能和皮质兴奋性的影响。

Effects of Low-Frequency (0.5 Hz) and High-Frequency (10 Hz) Repetitive Transcranial Magnetic Stimulation on Neurological Function, Motor Function, and Excitability of Cortex in Ischemic Stroke Patients.

机构信息

Department of Rehabilitation Medicine, The People's Hospital of Longhua District, Shenzhen, Guangdong Province, People's Republic of China.

出版信息

Neurologist. 2023 Jan 1;28(1):11-18. doi: 10.1097/NRL.0000000000000435.

Abstract

BACKGROUND

Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neuromodulation technique. The purpose of our study is to explore the effects of low-frequency (0.5 Hz) and high-frequency (10 Hz) rTMS on neurological function, motor function, and excitability of cortex in Chinese ischemic stroke patients.

MATERIALS AND METHODS

A total of 240 ischemic stroke patients were collected. The National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), motor-evoked potential (MEP) cortical latency, central motor conduction time (CMCT), Fugel-Meyer assessment (FMA), Berg balance scale (BBS), and modified Barthel index (MBI) scores were recorded.

RESULTS

After treatment, the NIHSS, mRS, MEP cortical latency, CMCT, FMA, BBS, and MBI scores of the high-frequency group and low-frequency group were significantly improved than the sham stimulation group, and the changes in the low-frequency group were more significant (adjusted P <0.05). Compared with the sham stimulation group, high-frequency stimulation reduced the NIHSS score by 9.5%, mRS score by 12.6%, MEP latency by 2.5%, and CMCT by 5.8%, and increased the upper limb FMA scale by 16.4%, lower limb FMA scale by 8.8%, BBS by 26.3%, and MBI by 9.3%, while low-frequency stimulation reduced the NIHSS score by 23.8%, mRS score by 25.3%, MEP Latency by 11.7%, and CMCT by 9.1%, and increased the upper limb FMA scale by 24.1%, lower limb FMA scale by 18.4%, BBS by 27.4%, and MBI by 23.7% in our cohort.

CONCLUSIONS

Low-frequency rTMS is better than high-frequency rTMS stimulation in improving neurological function, motor function, and excitability of cortex in ischemic stroke.

摘要

背景

重复经颅磁刺激(rTMS)是一种非侵入性的神经调节技术。我们的研究目的是探索低频(0.5Hz)和高频(10Hz)rTMS 对中国缺血性脑卒中患者的神经功能、运动功能和皮质兴奋性的影响。

材料和方法

共纳入 240 例缺血性脑卒中患者。记录国立卫生研究院卒中量表(NIHSS)、改良 Rankin 量表(mRS)、运动诱发电位(MEP)皮质潜伏期、皮质运动传导时间(CMCT)、Fugel-Meyer 评估(FMA)、Berg 平衡量表(BBS)和改良巴氏指数(MBI)评分。

结果

治疗后,高频组和低频组的 NIHSS、mRS、MEP 皮质潜伏期、CMCT、FMA、BBS 和 MBI 评分均显著优于假刺激组,且低频组的变化更为显著(调整 P<0.05)。与假刺激组相比,高频刺激使 NIHSS 评分降低 9.5%,mRS 评分降低 12.6%,MEP 潜伏期降低 2.5%,CMCT 降低 5.8%,上肢 FMA 量表增加 16.4%,下肢 FMA 量表增加 8.8%,BBS 增加 26.3%,MBI 增加 9.3%,而低频刺激使 NIHSS 评分降低 23.8%,mRS 评分降低 25.3%,MEP 潜伏期降低 11.7%,CMCT 降低 9.1%,上肢 FMA 量表增加 24.1%,下肢 FMA 量表增加 18.4%,BBS 增加 27.4%,MBI 增加 23.7%。

结论

低频 rTMS 刺激在改善缺血性脑卒中患者的神经功能、运动功能和皮质兴奋性方面优于高频 rTMS 刺激。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1e0/9812416/b983696102b4/nrl-28-11-g001.jpg

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