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重复经颅磁刺激作为持续性姿势-感知性头晕的辅助治疗方法

Repetitive transcranial magnetic stimulation as add-on the rapyin persistent postural-perceptual dizziness.

作者信息

Jia Yao, Wang Hongbin, Li Dan, Wu Xingli, Yang Jiawen, Min Weifei, Ma Ting, Huang He, Li Rui

机构信息

Department of Rehabilitation, Shangluo Central Hospital, Shaanxi 726000, PR China.

Department of Neurology, Shaanxi Provincial People's Hospital, Xi'an 710061, PR China.

出版信息

IBRO Neurosci Rep. 2024 Oct 29;17:382-388. doi: 10.1016/j.ibneur.2024.10.005. eCollection 2024 Dec.

Abstract

BACKGROUND

This study aims to evaluate the clinical effectiveness of repetitive transcranial magnetic stimulation (rTMS) when used as an add-on therapy for individuals with persistent postural-perceptual dizziness (PPPD).

METHODS

In this randomized controlled, double-blind trial conducted at Shangluo Central Hospital, patients with PPPD diagnosed in the neurology departments were included. Participants were randomized into a rTMS treatment group and a control group in a 1:1 ratio by the randomized grouping method. Patients in both groups received conventional treatment, with the rTMS treatment group underwent daily rTMS sessions, whereas the control group received sham rTMS treatments following the same schedule. The effectiveness of the treatments was primarily assessed using the Dizziness Handicap Inventory (DHI), Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD), which measured symptoms of vertigo, anxiety, and depression at baseline, after two weeks, and at the end of four weeks.

FINDINGS

Of the 46 participants recruited, 2 were excluded due to contraindications, 22 were randomly assigned to the rTMS treatment group, and 22 were assigned to the control group. Ultimately, 2 withdrew for personal reasons, and data from 42 participants were included in the outcome analysis. HAMA, HAMD and DHI scores were significantly lower in the rTMS treatment group than in the control group after 4 weeks of treatment (p<0.05). A positive correlation was also observed between DHI scores and HAMA or HAMD scores.

CONCLUSIONS

This pilot study demonstrated that rTMS is a beneficial add-on therapy for patients with PPPD.

摘要

背景

本研究旨在评估重复经颅磁刺激(rTMS)作为持续性姿势-感知性头晕(PPPD)患者附加治疗的临床效果。

方法

在商洛市中心医院进行的这项随机对照双盲试验中,纳入了在神经内科诊断为PPPD的患者。采用随机分组方法将参与者按1:1的比例随机分为rTMS治疗组和对照组。两组患者均接受常规治疗,rTMS治疗组每天进行rTMS治疗,而对照组按照相同时间表接受假rTMS治疗。主要使用头晕残障量表(DHI)、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评估治疗效果,这些量表在基线、两周后和四周结束时测量眩晕、焦虑和抑郁症状。

结果

在招募的46名参与者中,2名因禁忌症被排除,22名被随机分配到rTMS治疗组,22名被分配到对照组。最终,2名因个人原因退出,42名参与者的数据纳入结果分析。治疗4周后,rTMS治疗组的HAMA、HAMD和DHI评分显著低于对照组(p<0.05)。DHI评分与HAMA或HAMD评分之间也观察到正相关。

结论

这项初步研究表明,rTMS是PPPD患者有益的附加治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e179/11570328/ee6fa62a824b/gr1.jpg

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