经颅磁刺激联合正中神经电刺激干预不同年龄段慢性意识障碍的效果

doi:10.3969/j.issn.1006-9771.2023.08.011

Abstract

Abstract:

Objective To investigate the effect of combination with repetitive transcranial magnetic stimulation (rTMS) and median nerve electrical stimulation (MNS) on patients with prolonged disorders of consciousness (pDOC) in different age.
Methods From January, 2021 to May, 2023, 93 patients with pDOC in the First Affiliated Hospital of Nanchang University were divided into young group (≤ 45 years old), middle-aged group (46 to 60 years old) and elderly group (> 60 years old). All the groups were treated with rTMS and MNS for four weeks. The Coma Recovery Scale-Revised (CRS-R), Glasgow Coma Scale (GCS), and Full Outline of Unresponsiveness Scale (FOUR) were used to evaluate the efficiency of awakening after treatment and the awakening ratios were compared among three groups weekly. Four weeks after treatment, regional cerebral blood flow (rCBF) was measured with CT perfusion imaging. The score of Glasgow Outcome Scale Extended (GOS-E) was compared six months after treatment.
Results From three weeks after treatment, the scores of CRS-R, GCS and FOUR increased in all groups (P < 0.05). After weekly treatment, there was no significant difference in the composition ratio of consciousness level and the awakening ratio among three groups (χ² < 11.057, P > 0.05). After four weeks of treatment, rCBF improved in three groups (|t| > 2.495, P < 0.05), however, there was no difference among three groups (F < 1.887, P > 0.05). There was no difference in the score of GOS-E at six months after treatment (F = 3.083, P = 0.055).
Conclusion rTMS combined with MNS is effective on pDOC patients in different ages, and elderly patients could also benefit from it.

Key words: prolonged disorder of consciousness, repetitive transcranial magnetic stimulation, median nerve electrical stimulation

CLC Number:

R741

MENG Xiangqiang, XIONG Qi, CHEN Gengfa, BAI Yang, ZOU Tianzi, FENG Zhen. Effect of repetitive transcranial magnetic stimulation combined with median nerve electrical stimulation on patients with prolonged disorders of consciousness in different age[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 940-947.

Figures/Tables 15

References 41

[1]	KANG J, HUANG L, TANG Y, et al. A dynamic model to predict long-term outcomes in patients with prolonged disorders of consciousness[J]. Aging, 2022, 14(2): 789-799. doi: 10.18632/aging.v14i2
[2]	ANDRIESSEN T, HORN J, FRANSCHMAN G, et al. Epidemiology, severity classification, and outcome of moderate and severe traumatic brain injury: a prospective multicenter study[J]. J Neurotr, 2011, 28(10): 2019-2031. doi: 10.1089/neu.2011.2034
[3]	LI Y, GU J, ZHOU J, et al. The epidemiology of traumatic brain injury in civilian inpatients of Chinese Military Hospitals, 2001-2007 [J]. Brain Injury, 2015, 29: 981-988. doi: 10.3109/02699052.2014.989405
[4]	GIACINO J, KATZ D, SCHIFF N, et al. Comprehensive systematic review update summary: Disorders of consciousness: report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology; the American Congress of Rehabilitation Medicine; and the National Institute on Disability, Independent Living, and Rehabilitation Research[J]. Arch Phys Med Rehabil, 2018, 99(9): 1710-1719. doi: 10.1016/j.apmr.2018.07.002
[5]	GIACINO J T, KATZ D I, SCHIFF N D, et al. Practice guideline update recommendations summary: disorders of consciousness[J]. Arch Phys Med Rehabil, 2018, 99(9): 1699-1709. doi: 10.1016/j.apmr.2018.07.001
[6]	邱卓英, 陈迪. 基于ICF的残疾和康复信息标准体系及其应用研究[J]. 中国康复理论与实践, 2014, 20(6): 501-507.
	QIU Z Y, CHEN D. ICF based disability and rehabilitation information standard and its applications[J]. Chin J Rehabil Theory Pract, 2014, 20(6): 501-507.
[7]	WANG P, LI H, GUO Y, et al. The feasibility and validity of the comprehensive ICF core set for stroke in Chinese clinical settings[J]. Clin Rehabil, 2014, 28(2): 159-171. doi: 10.1177/0269215513496659 pmid: 23945163
[8]	ESTRANEO A, LORETO V, MASOTTA O, et al. Do medical complications impact long-term outcomes in prolonged disorders of consciousness?[J]. Arch Phys Med Rehabil, 2018, 99(12): 2523-2531. doi: 10.1016/j.apmr.2018.04.024
[9]	NEKRASOVA J, KANARSKII M, BORISOV I, et al. One-year demographical and clinical indices of patients with chronic disorders of consciousness[J]. Brain Sci, 2021, 11(5): 651. doi: 10.3390/brainsci11050651
[10]	邹波. 中国老龄化的现状与积极应对[J]. 中国民政, 2017, (20): 42-44.
	ZOU B. Status quo of China's population ageing and positive response on it[J]. Chin Civil Affairs, 2017, (20): 42-44.
[11]	QU B, LI X, LIU J, et al. Analysis of the current situation regarding the aging rural population in China and proposed countermeasures[J]. Popul Health Manag, 2012, 15(3): 181-185. doi: 10.1089/pop.2011.0033 pmid: 22401147
[12]	马岚. 从世界知识到中国认识:老龄化概念的中国化过程和积极老龄观的构建[J]. 经济社会体制比较, 2023(3): 64-72.
[13]	王薇, 程珺霞, 颜流霞, 等. 2015—2019年中国10个监测点人群脑卒中发病情况分析[J]. 现代预防医学, 2022, 49(24): 4524-4528.
	WANG W, CHENG J X, YAN L X, et al. Analysis on stroke incidence in 10 surveillance sites in China, 2015-2019 [J]. Modern Prev Med, 2022, 49(24): 4524-4528.
[14]	WANG W, JIANG B, SUN H, et al. Prevalence, incidence, and mortality of stroke in China: results from a nationwide population-based survey of 480 687 adults[J]. Circulation, 2017, 135(8): 759-771. doi: 10.1161/CIRCULATIONAHA.116.025250 pmid: 28052979
[15]	石艳红, 邵秀芹, 冯珍, 等. 正中神经电刺激与常规疗法治疗昏迷患者促醒疗效的Meta分析[J]. 中国康复医学杂志, 2017, 32(11): 1273-1277.
	SHI Y H, SHAO X Q, FENG Z, et al. Meta-analysis of effectiveness for median nerve electrical stimulation and traditional treatment in restoring consciousness in coma patients[J]. Chin J Rehabil Med, 2017, 32(11): 1273-1277.
[16]	FELLER D, VINANTE C, TRENTIN F, et al. The effectiveness of median nerve electrical stimulation in patients with disorders of consciousness: a systematic review[J]. Brain Inj, 2021, 35(4): 385-394. doi: 10.1080/02699052.2021.1887522 pmid: 33617359
[17]	FENG Y, ZHANG J, ZHOU Y, et al. Noninvasive brain stimulation for patients with a disorder of consciousness: a systematic review and meta-analysis[J]. [ahead of print]. Rev Neurosci, 2020. doi: 10.1515/revneuro-2020-0033.
[18]	XIONG Q, LE K, TANG Y, et al. Effect of single and combined median nerve stimulation and repetitive transcranial magnetic stimulation in patients with prolonged disorders of consciousness: a prospective, randomized, single-blinded, controlled trial[J]. Front Aging Neurosci, 2023, 15: 1112768. doi: 10.3389/fnagi.2023.1112768
[19]	李元朋, 魏欢. 正中神经电刺激配合rTMS对颅脑损伤患者的促醒作用研究[J]. 海南医学, 2022, 33(16): 2060-2063.
	LI Y P, WEI H. Effect of median nerve electrical stimulation combined with rTMS on arousal in patients with craniocerebral injury[J]. Hainan Med J, 2022, 33(16): 2060-2063.
[20]	中国医师协会神经修复专业委员会意识障碍与促醒学组. 慢性意识障碍诊断与治疗中国专家共识[J]. 中华神经医学杂志, 2020, 19(10): 977-982.
	Group of Disorders of Consciousness and Conscious-promotion, Professional Committee of Neurorepair of Chinese Medical Doctor Association. Diagnoses and treatments of prolonged disorders of consciousness: an experts consensus[J]. Chin J Neuromed, 2020, 19(10): 977-982.
[21]	陈星霖. 中国老年人健康的社会经济影响因素及时空演化研究[D]. 太原: 山西财经大学, 2022.
	CHEN X L. Study on the influence of socioeconomic factors and spatiotemporal evolution on the health of the elderly in China[D]. Taiyuan: Shanxi University of Finance and Economics, 2022.
[22]	World Health Organization. International Classification of Diseases 11th Revision [EB/OL]. [2018-08-17]. https://icd.who.int/browse11.
[23]	LAUREYS S, CELESIA G, COHADON F, et al. Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome[J]. BMC Med, 2010, 8: 68. doi: 10.1186/1741-7015-8-68 pmid: 21040571
[24]	GIACINO J, ASHWAL S, CHILDS N, et al. The minimally conscious state: definition and diagnostic criteria[J]. J Neurol, 2002, 58(3): 349-353.
[25]	XIONG Q, WANG Y, WANG Z, et al. Relationship between consciousness level and perfusion computed tomography in patients with prolonged disorders of consciousness[J]. Aging, 2022, 14(23): 9668-9678.
[26]	YOKOYAMA T, KAMEI T, KANNO T. Right median nerve stimulation for comatose patients[J]. Soc Treat Coma, 1996, 5: 117-125.
[27]	COOPER J, JANE J, ALVES W, et al. Right median nerve electrical stimulation to hasten awakening from coma[J]. Brain Injury, 1999, 13(4): 261-267. pmid: 10230527
[28]	LIU Y, LIU Z, YANG Z, et al. Clinical efficacy of hyperbaric oxygen combined with different timings of right median-nerve electrical stimulation in patients with brain injury-induced disorders of consciousness[J]. Brain Behav, 2022, 12(9): e2716. doi: 10.1002/brb3.v12.9
[29]	NEKKANTI S, SHAIK R, MONDEM S, et al. Effect of right median nerve stimulation on level of consciousness in traumatic brain injury subjects[J]. Asian J Pharmaceut Res Health Care, 2016, 8(3): 67.
[30]	WU X, XIE L, LEI J, et al. Acute traumatic coma awakening by right median nerve electrical stimulation: a randomised controlled trial[J]. Intensive Care Med, 2023, 49(6): 633-644. doi: 10.1007/s00134-023-07072-1 pmid: 37178149
[31]	谢瑛, 何院娟, 陈滟, 等. 重复经颅磁刺激对脑损伤后意识障碍患者脑血流速度及神经电生理的影响[J]. 中华临床医师杂志(电子版), 2011, 5(18): 5375-5379.
	XIE Y, HE Y J, CHEN Y, et al. Effect on cerebral blood flow velocity and electroneurophysiology in unconscious patients with brain injury after repetitive transcranial magnetic stimulation[J]. Chin J Clin (Electr Ed), 2011, 5(18): 5375-5379.
[32]	CHEUNG M K, HUNG A T, POON P K, et al. Validation of the World Health Organization Assessment Schedule II Chinese Traditional Version (WHODAS II CT) in persons with disabilities and chronic illnesses for Chinese population[J]. Disabil Rehabil, 2015, 37(20): 1902-1907. doi: 10.3109/09638288.2014.989336 pmid: 25495681
[33]	NAPOLI S B, VITALE M P, CAFIERO P J, et al. Developing a culturally sensitive ICF-based tool to describe functioning of children with autism spectrum disorder: TEA-CIFunciona Version 1.0 Pilot Study[J]. Int J Environ Res Public Health, 2021, 18(7): 3720. doi: 10.3390/ijerph18073720
[34]	CIEZA A, KIRCHBERGER I, BIERING-SØRENSEN F, et al. ICF Core Sets for individuals with spinal cord injury in the long-term context[J]. Spinal Cord, 2010, 48(4): 305-312. doi: 10.1038/sc.2009.183 pmid: 20065984
[35]	陈庚发. 基于ICF框架构建意识障碍患者评估类目及临床应用评价[D]. 南昌: 南昌大学, 2022.
	CHEN G F. Construction of assessment categories and clinical application evaluation of patients with disorders of consciousness based on the ICF framework[D]. Nanchang: Nanchang University, 2022.
[36]	CABEZA R, ALBERT M, BELLEVILLE S, et al. Publisher Correction: Maintenance, reserve and compensation: the cognitive neuroscience of healthy ageing[J]. Nature Rev Neurosci, 2018, 19(12): 772.
[37]	RAZ N, LINDENBERGER U, RODRIGUE K, et al. Regional brain changes in aging healthy adults: general trends, individual differences and modifiers[J]. Cerebral Cortex, 2005, 15(11): 1676-1689. doi: 10.1093/cercor/bhi044 pmid: 15703252
[38]	ZHENG X, CHEN M, LI J, et al. Prognosis in prolonged coma patients with diffuse axonal injury assessed by somatosensory evoked potentia[J]. Neural Regener Res, 2013, 8(10): 948-954.
[39]	ESTRANEO A, FIORENZA S, MAGLIACANO A, et al. Multicenter prospective study on predictors of short-term outcome in disorders of consciousness[J]. Neurology, 2020, 95(11): e1488-e1499.
[40]	WHYTE J, GOSSERIES O, CHERVONEVA I, et al. Predictors of short-term outcome in brain-injured patients with disorders of consciousness[J]. Progress Brain Res, 2009, 177: 63-72.
[41]	赵继宗. 意识障碍临床诊疗的现状与进展[J]. 临床神经外科杂志, 2020, 17(1): 1-3, 7.
	ZHAO J Z. Clinical diagnosis and treatment of consciousness disorders[J]. J Clin Neurosurg, 2020, 17(1): 1-3, 7.

组别	n	性别(男/女)/n	病程/d	意识水平(VS/MCS-/MCS+)/n	工作状态 (有/无)/n	婚姻状态 (已婚/未婚)/n	教育水平(小学及以下/初中或高中/大学及以上)/n	病因(脑外伤/脑卒中/缺血缺氧性)/n
青年组	18	13/5	65.83±33.42	5/12/1	9/9	10/8	2/12/4	9/7/2
中年组	39	21/18	47.26±33.47	20/16/3	25/14	38/1	13/23/3	14/24/1
老年组	36	18/18	45.33±41.21	20/14/2	19/17	36/0	20/16/0	14/20/2
F/χ²值		2.521	2.078	4.495	1.424	31.006	15.794	3.462
P值		0.284	0.131	0.343	0.491	< 0.001	0.003	0.484

组别	n	治疗前	治疗1周	治疗2周	治疗3周	治疗4周
青年组	14	7.43±1.95	8.07±2.46	9.00±2.66	10.93±3.10^a	14.79±4.54^a
中年组	31	6.90±2.66	7.26±2.57	8.55±3.22	9.84±3.92^a	12.10±5.33^a
老年组	31	6.77±2.84	7.81±3.36	9.61±4.29	10.90±5.07^a	12.23±5.57^a
F值		0.307	0.473	0.673	0.568	1.405
P值		0.737	0.625	0.513	0.569	0.252

组别	n	治疗前	治疗1周	治疗2周	治疗3周	治疗4周
青年组	14	8.64±1.78	9.21±1.31	9.50±1.34	10.07±1.59^a	11.86±1.92^a
中年组	31	7.61±1.50	8.00±1.75	8.58±2.06	9.65±2.30^a	10.55±2.78^a
老年组	31	7.55±1.93	8.06±1.82	8.97±1.94	9.74±2.07^a	10.81±2.64^a
F值		2.146	2.730	1.153	0.203	1.266
P值		0.124	0.072	0.321	0.817	0.288

组别	n	治疗前	治疗1周	治疗2周	治疗3周	治疗4周
青年组	14	11.57±1.91	12.36±2.10	13.07±1.77	13.79±1.93^a	14.57±1.87^a
中年组	31	11.23±1.69	11.77±2.46	12.26±2.18	13.06±2.14^a	14.03±2.30^a
老年组	31	10.68±2.34	11.35±2.47	12.55±2.34	13.13±2.46^a	13.94±2.26^a
F值		1.110	0.857	0.675	0.545	0.417
P值		0.335	0.429	0.512	0.582	0.661

组别	n	治疗1周				治疗2周				治疗3周				治疗4周
组别	n	VS	MCS-	MCS+	EMCS	VS	MCS-	MCS+	EMCS	VS	MCS-	MCS+	EMCS	VS	MCS-	MCS+	EMCS
青年组	14	4	9	1	0	3	9	2	0	2	8	4	0	2	2	4	6
中年组	31	17	11	3	0	13	13	5	0	13	12	3	3	11	3	6	11
老年组	31	17	11	3	0	16	10	4	1	14	6	7	4	10	6	4	11
χ²值		3.978				6.001				11.057				3.983
P值		0.409				0.423				0.087				0.679

Effect of repetitive transcranial magnetic stimulation combined with median nerve electrical stimulation on patients with prolonged disorders of consciousness in different age

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组别	n	治疗1周	治疗2周	治疗3周	治疗4周
青年组	14	0	14.29	35.71	71.43
中年组	31	6.45	19.35	32.26	61.29
老年组	31	3.23	16.13	45.16	64.52
χ²值		1.131	0.210	1.398	0.243
P值		0.568	0.900	0.497	0.886

组别	n	治疗前	治疗4周后	t值	P值
青年组	14	60.70±11.81	80.51±8.72	-4.998	< 0.001
中年组	31	60.98±10.23	79.83±10.33	-7.678	< 0.001
老年组	31	60.08±11.09	79.12±8.45	-7.206	< 0.001
F值		0.047	0.076
P值		0.954	0.927

组别	n	治疗前	治疗4周后	t值	P值
青年组	14	48.12±8.07	77.37±5.93	-9.985	< 0.001
中年组	31	51.11±11.22	74.97±9.48	-8.874	< 0.001
老年组	31	48.06±10.36	71.38±10.89	-7.972	< 0.001
F值		0.689	1.419
P值		0.506	0.252

组别	n	治疗前	治疗4周后	t值	P值
青年组	14	77.96±7.94	92.67±6.26	-5.385	< 0.001
中年组	31	74.78±8.51	91.76±8.83	-7.017	< 0.001
老年组	31	71.69±7.69	89.71±5.83	-9.196	< 0.001
F值		2.668	0.677
P值		0.077	0.513

组别	n	治疗前	治疗4周后	t值	P值
青年组	14	67.25±11.18	81.22±10.70	-3.946	0.001
中年组	31	63.66±9.11	79.89±7.49	-6.850	< 0.001
老年组	31	61.04±9.40	81.05±9.99	-7.157	< 0.001
F值		1.799	0.102
P值		0.174	0.903

组别	n	治疗前	治疗4周后	t值	P值
青年组	14	67.32±4.28	86.70±3.58	-9.774	< 0.001
中年组	31	62.68±10.87	81.78±9.97	-7.039	< 0.001
老年组	31	66.04±7.78	86.58±8.46	-8.608	< 0.001
F值		1.599	1.887
P值		0.210	0.163

组别	n	治疗前	治疗4周后	t值	P值
青年组	14	61.43±5.72	80.93±5.53	-2.495	0.020
中年组	31	55.19±11.39	75.71±10.39	-2.900	0.005
老年组	31	56.26±11.15	77.68±9.99	-6.731	< 0.001
F值		1.644	0.921
P值		0.201	0.406

组别	n	治疗前	治疗4周后	t值	P值
青年组	14	63.16±8.14	83.20±9.21	-4.984	< 0.001
中年组	31	63.56±10.50	81.16±8.26	-6.999	< 0.001
老年组	31	60.78±6.03	79.01±6.55	-10.409	< 0.001
F值		0.752	1.001
P值		0.476	0.375

组别	n	治疗前	治疗4周后	t值	P值
青年组	14	52.65±9.93	73.23±11.18	-4.414	< 0.001
中年组	31	53.53±10.87	74.05±9.83	-7.452	< 0.001
老年组	31	50.23±8.27	70.61±7.77	-9.201	< 0.001
F值		0.780	0.729
P值		0.463	0.488

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[14]	WANG Min,YAO Tao-tao,LI Jia-yin,LIN Yu-yi,ZHENG Liang. Advance in Repeatitive Transcranial Magnetic Stimulation for Dysphagia after Stroke (review) [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(5): 555-558.
[15]	GULIJIAKELA Ai-shan,CHEN Chan,GAO Tian-hao,LING Jun-qi,SUN Li-min,BAI Yu-long. Effect of Repetitive Transcranial Magnetic Stimulation Combined with Conventional Rehabilitation on Upper Extremity Function for A Patient with Complex Regional Pain Syndrome I after Distal Radius Fracture [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(2): 232-236.