经颅磁刺激对伴有认知障碍和失语症的中风后患者的神经心理学及解剖学-功能影响:一项系统评价

Neuropsychological and Anatomical-Functional Effects of Transcranial Magnetic Stimulation in Post-Stroke Patients with Cognitive Impairment and Aphasia: A Systematic Review.

作者信息

Pezoa-Peña Ignacio, Julio-Ramos Teresa, Cigarroa Igor, Martella Diana, Solomons Daniel, Toloza-Ramirez David

机构信息

Master's program in Neuroscience, Universidad Autonoma de Chile, Temuco, Chile.

Laboratory of Language Rehabilitation and Stimulation (LARES), Speech and Language Therapy School, Health Sciences Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Neuropsychol Rev. 2024 Jun 13. doi: 10.1007/s11065-024-09644-4.

Abstract

Transcranial magnetic stimulation (TMS) has been found to be promising in the neurorehabilitation of post-stroke patients. Aphasia and cognitive impairment (CI) are prevalent post-stroke; however, there is still a lack of consensus about the characteristics of interventions based on TMS and its neuropsychological and anatomical-functional benefits. Therefore, studies that contribute to creating TMS protocols for these neurological conditions are necessary. To analyze the evidence of the neuropsychological and anatomical-functional TMS effects in post-stroke patients with CI and aphasia and determine the characteristics of the most used TMS in research practice. The present study followed the PRISMA guidelines and included articles from PubMed, Scopus, Web of Science, ScienceDirect, and EMBASE databases, published between January 2010 and March 2023. In the 15 articles reviewed, it was found that attention, memory, executive function, language comprehension, naming, and verbal fluency (semantic and phonological) are the neuropsychological domains that improved post-TMS. Moreover, TMS in aphasia and post-stroke CI contribute to greater frontal activation (in the inferior frontal gyrus, pars triangularis, and opercularis). Temporoparietal effects were also found. The observed effects occur when TMS is implemented in repetitive modality, at a frequency of 1 Hz, in sessions of 30 min, and that last more than 2 weeks in duration. The use of TMS contributes to the neurorehabilitation process in post-stroke patients with CI and aphasia. However, it is still necessary to standardize future intervention protocols based on accurate TMS characteristics.

摘要

经颅磁刺激(TMS)已被发现在中风后患者的神经康复中具有前景。失语症和认知障碍(CI)在中风后很常见;然而,对于基于TMS的干预措施的特征及其神经心理学和解剖功能益处,仍然缺乏共识。因此,有必要开展有助于为这些神经系统疾病制定TMS方案的研究。分析TMS对中风后患有CI和失语症患者的神经心理学及解剖功能影响的证据,并确定研究实践中最常用的TMS的特征。本研究遵循PRISMA指南,纳入了2010年1月至2023年3月期间发表于PubMed、Scopus、科学网、ScienceDirect和EMBASE数据库的文章。在所审查的15篇文章中发现,注意力、记忆力、执行功能、语言理解、命名和言语流畅性(语义和语音)是TMS治疗后得到改善的神经心理学领域。此外,针对失语症和中风后CI的TMS有助于增强额叶激活(在额下回、三角部和盖部)。还发现了颞顶叶效应。当以1赫兹的频率、30分钟的时长、重复模式实施TMS且持续时间超过2周时,会观察到上述效果。TMS的使用有助于中风后患有CI和失语症患者的神经康复过程。然而,仍有必要根据准确的TMS特征规范未来的干预方案。

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