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兴奋性间歇性θ波刺激对不完全性脊髓损伤患者下肢恢复的疗效

Efficacy of Excitatory iTBS on Lower Limb Recovery in iSCI Patients.

作者信息

Shi Shengliu, Yao Jingyu, Cai Jing

机构信息

Department of Rehabilitation Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, P.R. China.

Department of Octolaryngology, First Affiliated Hospital of Kunming Medical University, Kunming, P.R. China.

出版信息

Global Spine J. 2025 Jun 3:21925682251343528. doi: 10.1177/21925682251343528.

DOI:10.1177/21925682251343528
PMID:40459847
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12133774/
Abstract

Study DesignProspective Study.ObjectiveSpinal cord injury leads to severe limitations in autonomy including locomotor function. Intermittent theta burst stimulation (iTBS) has shown promising therapeutic effects on various neuropsychiatric disorders. We analyzed the efficacy of excitatory iTBS on motor and walking functions in patients with incomplete spinal cord injury (iSCI).MethodsThe prospectively selected iSCI patients were divided into the iTBS (n = 69) and sham-iTBS (n = 69) groups, and underwent iTBS and sham-iTBS treatment, respectively, followed by conventional physiotherapy. Clinical assessments were conducted on the muscle strength of quadriceps, gluteus maximus, hamstring, tibialis anterior and gastrocnemius muscle, lower extremity motor score (LEMS), walking speed (WS), stride length (SL), Berg balance scale (BBS), Holden walking ability scale (HWAS) score, the static eyes-open and eyes-closed center of gravity locus length, and the modified Barthel index (MBI) score.ResultsThere were no significant differences among all patients in baseline data. After 9-week treatment, all the patients had notably elevated muscle strength levels of quadriceps, gluteus maximus, hamstring, tibialis anterior and gastrocnemius, WS, SL, and HWAS, BBS, LEMS and MBI scores, as well as decreased static eyes-open and eyes-closed center of gravity locus length, with the changes more remarkable in the patients treated with iTBS. The total effective rate for patients treated with iTBS was 86.96%, which was apparently higher than that of patients treated with sham-iTBS.ConclusionExcitatory iTBS significantly improved lower limb strength and walking function in iSCI patients.

摘要

研究设计

前瞻性研究。

目的

脊髓损伤会导致包括运动功能在内的自主能力严重受限。间歇性θ波爆发刺激(iTBS)已在各种神经精神疾病中显示出有前景的治疗效果。我们分析了兴奋性iTBS对不完全性脊髓损伤(iSCI)患者运动和步行功能的疗效。

方法

前瞻性选择的iSCI患者被分为iTBS组(n = 69)和假iTBS组(n = 69),分别接受iTBS和假iTBS治疗,随后进行常规物理治疗。对股四头肌、臀大肌、腘绳肌、胫前肌和腓肠肌的肌力、下肢运动评分(LEMS)、步行速度(WS)、步幅长度(SL)、伯格平衡量表(BBS)、霍尔登步行能力量表(HWAS)评分、静息睁眼和闭眼重心轨迹长度以及改良巴氏指数(MBI)评分进行临床评估。

结果

所有患者的基线数据无显著差异。经过9周治疗后,所有患者的股四头肌、臀大肌、腘绳肌、胫前肌和腓肠肌的肌力水平、WS、SL以及HWAS、BBS、LEMS和MBI评分均显著提高,静息睁眼和闭眼重心轨迹长度缩短,iTBS治疗的患者变化更显著。iTBS治疗患者的总有效率为86.96%,明显高于假iTBS治疗的患者。

结论

兴奋性iTBS显著改善了iSCI患者的下肢力量和步行功能。

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本文引用的文献

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Can cerebellar theta-burst stimulation improve balance function and gait in stroke patients? A randomized controlled trial.小脑 theta 爆发刺激能否改善脑卒中患者的平衡功能和步态?一项随机对照试验。
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Mechanisms of intermittent theta-burst stimulation attenuating nerve injury after ischemic reperfusion in rats through endoplasmic reticulum stress and ferroptosis.间歇 theta 爆发刺激通过内质网应激和铁死亡减轻大鼠缺血再灌注后神经损伤的机制。
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