《中国康复理论与实践》

《中国康复理论与实践》 ›› 2015, Vol. 21 ›› Issue (02): 216-219.

• 临床研究 • 上一篇    下一篇

1 Hz重复经颅磁刺激对缺血性脑卒中后上肢运动功能的疗效

赵利娜，张志强，张立新，梁维娣
  

  1. 中国医科大学附属盛京医院康复中心，辽宁沈阳市110000。
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-02-25 发布日期:2015-02-25

Effect of 1 Hz Repetitive Transcranial Magnetic Stimulation on Upper Limb Motor Function after Stroke

ZHAO Li- na, ZHANG Zhi-qiang, ZHANG Li-xin, LIANG Wei-di   

  1. Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-02-25 Online:2015-02-25

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摘要： 目的观察1 Hz重复经颅磁刺激(rTMS)对缺血性脑卒中后偏瘫上肢运动功能康复的效果。方法40 例缺血性脑卒中后上肢偏瘫患者被随机分配到治疗组(n=20)和对照组(n=20)。两组均给予常规康复治疗，治疗组采用rTMS 刺激健侧皮层M1 区，对照组给予假刺激。治疗后采用运动诱发电位(MEPs)、Fugl-Meyer 上肢运动功能评分(FMA)和握力进行评定。结果治疗后，治疗组患侧MEPs振幅显著升高(P<0.001)。治疗组握力和FMA评分显著优于对照组(P<0.001)，并至少可持续到治疗结束后1 个月。所有患者均能耐受10 次治疗，无严重不良反应发生。结论rTMS 刺激健侧皮层M1 区可改善缺血性脑卒中后偏瘫上肢的运动功能。

关键词: 脑卒中, 经颅磁刺激, 皮质兴奋性, 上肢, 运动功能

Abstract: Objective To observe the effect of 1 Hz repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function after stroke. Methods 40 patients with ischemic internal carotid artery (ICA) stroke were randomly divided into treatment group (n=20) and control group (n=20). Both groups received conventional rehabilitation and medication. The treatment group received rTMS while the control group received pseudo stimulation, 1 Hz at 100% resting motor threshold (RMT) over contralesional motor cortex (unaffected side). The treatment group was tested with motor evoked potentials (MEPs), and both groups were assessed with Fugl-Meyer Assessment (FMA) and grip strength after treatment. Results The amplitude of MEPs of the unaffected cortex increased in the treatment group after treatment (P< 0.001). The treatment group improved in grip strength and the scores of FMA in the affected side compared with the control group after treatment (P<0.001). No serious side-effect was found. Conclusion rTMS was safe and feasible for patients with ischemic ICA stroke to improve the upper limb motor function.

Key words: stroke, transcranial magnetic stimulation, cortical excitability, upper limb, motor function