多靶点重复经颅磁刺激改善帕金森病步态冻结：一项随机对照试验

Multi-Target Repetitive Transcranial Magnetic Stimulation Improves Freezing of Gait in Parkinson's Disease: A Randomized Controlled Trial.

作者信息

Zhang Zixuan, Liu Danyang, Song Wenjing, Li Jinyu, Wang Xi, Yin Peixiao, Liu Yuning, Xu Min, Li Fujia, Li Yumeng, Cui Guiyun, Zhang Wei

机构信息

Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.

Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, China.

出版信息

CNS Neurosci Ther. 2025 Aug;31(8):e70582. doi: 10.1111/cns.70582.

DOI:10.1111/cns.70582

PMID:40847522

Abstract

OBJECTIVE

In this randomized, double-blind, sham-controlled trial, we investigated the efficacy of multi-target 10-Hz rTMS targeting both M1 and SMA in alleviating freezing of gait (FOG) in Parkinson's disease (PD) patients.

METHODS

Eighty-four PD-FOG patients were randomly assigned (1:1:1:1) to four groups: M1 and SMA group, M1 group, SMA group, and sham group. rTMS was administered once daily for 10 consecutive days. Assessments were conducted at baseline (T0), after the final session (T1), and 30 days posttreatment (T2), using the FOG-Q, UPDRS-III, Timed Up and Go (TUG) Test, Standing-Start 180° Turn (SS-180) Test, and measures of emotion and cognition.

RESULTS

Application of 10-Hz rTMS to bilateral M1 or SMA significantly reduced FOG severity, improved motor function, and alleviated emotional disturbances in PD patients, with effects lasting at least 1 month. Compared to single-target stimulation, multi-target stimulation of M1 and SMA high-frequency rTMS showed more pronounced therapeutic effects across these outcomes. However, no significant cognitive improvements were observed in either the real or sham stimulation groups.

CONCLUSIONS

The results of this study indicate that bilateral M1 and SMA 10-Hz rTMS is a promising therapeutic approach, providing new possibilities for clinical treatment.

摘要

目的

在这项随机、双盲、假刺激对照试验中，我们研究了多靶点10赫兹重复经颅磁刺激（rTMS）同时作用于初级运动皮层（M1）和辅助运动区（SMA）对缓解帕金森病（PD）患者冻结步态（FOG）的疗效。

方法

84例PD-FOG患者被随机分为四组（1:1:1:1）：M1和SMA组、M1组、SMA组和假刺激组。rTMS每天给药1次，连续给药10天。在基线期（T0）、最后一次治疗后（T1）和治疗后30天（T2）进行评估，使用FOG问卷（FOG-Q）、统一帕金森病评定量表第三部分（UPDRS-III）、计时起立行走测试（TUG测试）、站立起始180°转身测试（SS-180测试）以及情绪和认知测量指标。