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序贯性促进性脑和小脑重复经颅磁刺激对亚急性卒中患者无额外影响。

No Additional Effects of Sequential Facilitatory Cerebral and Cerebellar rTMS in Subacute Stroke Patients.

作者信息

Lee Ho Seok, Kim Sungwon, Kim Heegoo, Baik Seung-Min, Kim Dae Hyun, Chang Won Hyuk

机构信息

Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.

Department of Health Sciences and Technology, Department of Medical Device Management & Research, Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul 06355, Republic of Korea.

出版信息

J Pers Med. 2024 Jun 26;14(7):687. doi: 10.3390/jpm14070687.

Abstract

The aim of this study was to investigate the additional effects of cerebellar rTMS on the motor recovery of facilitatory rTMS over affected primary motor cortex (M1) in subacute stroke patients. Twenty-eight subacute stroke patients were recruited in this single-blind, randomized, controlled trial. The Cr-Cbll group received Cr-Cbll rTMS stimulation consisting of high-frequency rTMS over affected M1 (10 min), motor training (10 min), and high-frequency rTMS over contralesional Cbll (10 min). The Cr-sham group received sham rTMS instead of high-frequency rTMS over the cerebellum. Ten daily sessions were performed for 2 weeks. A Fugl-Meyer Assessment (FMA) was measured before (T0), immediately after (T1), and 2 months after the intervention (T2). A total of 20 participants (10 in the Cr-Cbll group and 10 in the Cr-sham group) completed the intervention. There was no significant difference in clinical characteristics between the two groups at T0. FMA was significantly improved after the intervention in both Cr-Cbll and Cr-sham groups ( < 0.05). However, there was no significant interaction in FMA between time and group. In conclusion, these results could not demonstrate that rTMS over the contralesional cerebellum has additional effects to facilitatory rTMS over the affected M1 for improving motor function in subacute stroke patients.

摘要

本研究旨在探讨小脑重复经颅磁刺激(rTMS)对亚急性脑卒中患者患侧初级运动皮层(M1)进行易化性rTMS时运动恢复的附加作用。在这项单盲、随机对照试验中招募了28例亚急性脑卒中患者。Cr-Cbll组接受Cr-Cbll rTMS刺激,包括对患侧M1进行高频rTMS(10分钟)、运动训练(10分钟)以及对健侧小脑进行高频rTMS(10分钟)。Cr-假刺激组接受假rTMS,而非对小脑进行高频rTMS。为期2周,每天进行10次治疗。在干预前(T0)、干预后即刻(T1)以及干预后2个月(T2)进行Fugl-Meyer评估(FMA)。共有20名参与者(Cr-Cbll组10名,Cr-假刺激组10名)完成了干预。在T0时,两组的临床特征无显著差异。干预后,Cr-Cbll组和Cr-假刺激组的FMA均显著改善(<0.05)。然而,FMA在时间和组间无显著交互作用。总之,这些结果无法证明对健侧小脑进行rTMS对患侧M1进行易化性rTMS改善亚急性脑卒中患者运动功能具有附加作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3211/11278256/f5a618b28319/jpm-14-00687-g001.jpg

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