间歇性Theta节律经颅磁刺激对脑卒中后非流利性失语的影响

doi:10.3969/j.issn.1006-9771.2023.07.014

Abstract

Abstract:

Objective To explore the therapeutic effect and mechanism of intermittent theta burst transcranial magnetic stimulation (iTBS) on non-fluent aphasia after stroke.

Methods From August, 2021 to August, 2022, 50 patients with non-fluent aphasia after stroke in the First People's Hospital of Lianyungang were randomly divided into sham stimulation group (n = 25) and iTBS group (n = 25). Both groups accepted speach training. iTBS group accepted iTBS, and the sham stimulation group received sham iTBS, for four weeks. The serum brain-derived neurotrophic factor (BDNF) was measured, and they were assessed by China Rehabilitation Research Center Standard Aphasia Examination (CRRCAE) and Boston Diagnostic Aphasia Examination before and after treatment.

Results Two cases in the sham stimulation group and three cases in iTBS group dropped down. The BDNF level, and listen and understand, repeat, name, read aloud, and total score of CRRCAE improved in two groups after treatment (|t| > 5.012, P < 0.001); and they were better in iTBS group than in the sham stimulation group (|t| > 3.968, P < 0.001). The total effective rate was more in iTBS group than in the sham stimulation group (χ² = 8.835, P < 0.05).

Conclusion iTBS can improve speech function in patients with non-fluent aphasia after stroke, which may associate with the promotion of BDNF.

Key words: stroke, non-fluent aphasia, transcranial magnetic stimulation, intermittent theta burst stimulation, speech

CLC Number:

R743.3

JIANG Xiaocui, LIU Zhen, SU Qinglun, ZHAO Qin, XIA Xiaomei, LU Fei. Effect of intermittent theta burst transcranial magnetic stimulation on non-fluent aphasia after stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 839-843.

Figures/Tables 4

References 23

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组别	n	性别(女/男)/n	年龄/岁	受教育年限/年	卒中类型 (脑梗死/脑出血)/n	病程/d	失语症类型(完全性失语/经皮质失语/Broca失语)/n
假刺激组	23	7/16	63.57±9.69	10.35±3.59	15/8	35.04±30.65	6/6/11
iTBS组	22	13/9	58.86±12.81	9.32±2.50	12/10	39.95±28.84	5/7/10
t/χ²值		3.740	1.392	1.113	0.534	-0.553	0.193
P值		0.053	0.171	0.272	0.465	0.593	0.908

组别	n	治疗前	治疗后	t值	P值
假刺激组	23	29.13±3.07	33.60±1.82	-9.324	< 0.001
iTBS组	22	29.77±3.06	39.19±1.81	-14.045	< 0.001
t值		-0.698	-10.323
P值		0.489	< 0.001

指标	假刺激组(n = 23)		iTBS组(n = 22)		假刺激组组内比较		iTBS组组内比较		两组训练前比较		两组训练后比较
指标	治疗前	治疗后	治疗前	治疗后	t值	P值	t值	P值	t值	P值	t值	P值
听理解	74.30±28.62	98.39±29.85	85.23±24.42	139.23±24.26	-8.850	< 0.001	-12.796	< 0.001	-1.374	0.176	-5.023	< 0.001
复述	51.09±19.59	89.35±21.96	59.64±20.56	133.14±27.10	-12.245	< 0.001	-11.506	< 0.001	-1.428	0.160	-5.968	< 0.001
命名	30.70±13.11	51.00±27.84	31.91±15.86	90.86±33.11	-5.012	< 0.001	-11.466	< 0.001	-0.280	0.781	-4.378	< 0.001
朗读	27.26±17.37	53.65±28.13	29.86±19.27	84.68±24.07	-6.124	< 0.001	-19.081	< 0.001	-0.476	0.636	-3.968	< 0.001
总分	271.43±90.12	417.78±112.19	310.95±69.35	628.63±97.20	-15.695	< 0.001	-21.550	< 0.001	-1.643	0.108	-6.725	< 0.001

组别	n	显效	有效	无效	总有效
假刺激组	23	7	8	8	15
iTBS组	22	10	8	4	18

Effect of intermittent theta burst transcranial magnetic stimulation on non-fluent aphasia after stroke

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