Department of Neurology, Affiliated Hospital and Medical School of Nantong University, Nantong, China.
Department of Neurology, The Peoples Hospital of Rugao, Nantong, China.
Medicine (Baltimore). 2024 Nov 29;103(48):e40689. doi: 10.1097/MD.0000000000040689.
This study explores the efficacy of repetitive transcranial magnetic stimulation (rTMS) and rTMS combined with repetitive peripheral magnetic stimulation (rPMS) (hereinafter referred to as rTMS + rPMS) on motor symptoms and quality of life in Parkinson's disease (PD), and explores whether there are differences between the two treatment methods; At the same time, analyze data from different subgroups to explore the influencing factors, in order to find the most suitable treatment group.
Eighty patients with PD were randomly divided into rTMS and rTMS + rPMS groups and administered 10 Hz rTMS, and 10 Hz rTMS + 25 Hz rPMS, respectively, for 10 days. Before and after treatment, the PD Motor Function Rating Scale (UPDRS Part III, 10m Walk Timing Test, Stand Up Walk Test Evaluation Scale (TUG)) and PD Quality of Life Questionnaire (PDQ-39) were used to evaluate the motor symptoms and quality of life. After quantifying the treatment effect, a comparative analysis of the efficacy before and after treatment was conducted. Simultaneously, we divided the two treatment groups into different subgroups, compared the subgroups under the same treatment method, analyzed the relevant factors affecting the treatment method, and found the most suitable treatment group.
(1) After rTMS or rTMS + rPMS, all scoring scales improved compared to those before treatment (P < .05). Compared to rTMS, rTMS + rPMS resulted in greater improvements in overall motor function (UPDRS III) and quality of life (PDQ-39) (P < .05). (2) Patients with rigidity-based type as the main type may be the most suitable for these two treatment methods (P < .05).(3) There was no significant difference in treatment efficiency between the two treatment methods for patients with PD at different disease stages, sexes, or treatment ages(P > .05).
Both rTMS and rTMS + rPMS can improve movement symptoms and quality of life in patients with PD. rTMS + rPMS was more beneficial for improving the overall motor function. Patients with rigidity-based type as the main type may be the most suitable for these two treatment methods. The therapies work in all age groups, all gender and irrespective of the disease stage with varying levodopa equivalent daily doses as well.
本研究旨在探讨重复经颅磁刺激(rTMS)和 rTMS 联合重复外周磁刺激(rPMS)(以下简称 rTMS+rPMS)对帕金森病(PD)运动症状和生活质量的疗效,并探讨两种治疗方法之间是否存在差异;同时,对不同亚组数据进行分析,以探讨影响因素,从而找到最适合的治疗组。
将 80 例 PD 患者随机分为 rTMS 组和 rTMS+rPMS 组,分别给予 10Hz rTMS 和 10Hz rTMS+25Hz rPMS 治疗,共 10 天。治疗前后采用 PD 运动功能评分量表(UPDRS Ⅲ部分、10m 步行计时试验、起立行走试验评估量表(TUG))和 PD 生活质量问卷(PDQ-39)评估运动症状和生活质量。量化治疗效果后,对治疗前后的疗效进行比较分析。同时,将两组治疗方法分为不同亚组,比较同一治疗方法下的亚组,分析影响治疗方法的相关因素,找到最适合的治疗组。
(1)rTMS 或 rTMS+rPMS 治疗后,各项评分均较治疗前改善(P<.05)。与 rTMS 相比,rTMS+rPMS 治疗后整体运动功能(UPDRS Ⅲ)和生活质量(PDQ-39)改善更明显(P<.05)。(2)以僵硬型为主的患者可能更适合这两种治疗方法(P<.05)。(3)不同疾病阶段、性别或治疗年龄的 PD 患者,两种治疗方法的治疗效率无显著差异(P>.05)。
rTMS 和 rTMS+rPMS 均可改善 PD 患者的运动症状和生活质量。rTMS+rPMS 更有利于改善整体运动功能。以僵硬型为主的患者可能更适合这两种治疗方法。两种治疗方法在所有年龄组、所有性别和无论疾病阶段以及等效左旋多巴日剂量如何均有效。