【摘要】 目的:探讨低频重复经颅磁刺激(rTMS)对PD患者运动皮质兴奋性影响的持续效应。方法:对38例PD患者,予0.5Hz rTMS刺激其主要受累肢体对侧的M1Hand(20×80,100%RMT),连续7d。于首次干预前及末次干预后20min、1周及1个月分别评价其临床运动功能和运动诱发电位。结果:低频rTMS干预后,PD患者UPDRS Ⅲ、僵直、运动迟缓评分、计时运动试验及CSP均存在显著时间效应(P<0.001)。结论:低频rTMS可改善PD患者运动迟缓症状,其对运动功能的影响可持续到刺激停止后1个月,与运动皮质兴奋性的改变一致。更多还原

【Abstract】 Aim:To inquire into the time effect of low-frequency repetitive transcranial magnetic stimulation(rTMS)on the excitability of motor cortex in Parkinson’s disease(PD)patients.Methods:38 patients with PD were included in this study.For seven consecutive days,we applied 1 800 stimuli at 100% RMT intensity and 0.5 Hz frequency over the M1Hand contralateral to the(more)affected side once a day using a figure-of-eight coil.The unified Parkinson’s disease rating scale(UPDRS),ballistic task,walking test and the motor evoked potentials were assessed for each patient before rTMS and 20 min,1week,and 1mon after the 7th session.Results:ANOVA for repeated measurements revealed a significant time effect for the global UPDRS and its motor section,rigidity and bradykinesia subscores,and the timed motor tasks during the course of the study(P<0.001).The PD patients clinical motor function was improved to the highest level within one week after the 7th intervention.The therapeutic effect of low frequency rTMS lasted one month.Whereas,no significant changes were observed in the tremor subscore(P=0.110).The effective ratio of bradykinesia subscores is 31.71%,which was assessed 20 min after the 7th intervention.There was also a significant time effect for the CSP duration(P<0.001),while no significant changes were found for the RMT,MEP120,and CMCT(P>0.05).Conclusion:A 7-day course of rTMS results in statistically significant long-term improvement of the motor functions in PD patients,which is paralleled by the changes in the excitability of the motor cortex.更多还原