李修齐,陈颖,吴军发,等.小脑间歇性θ短阵脉冲刺激对健康人双侧大脑运动皮质兴奋性的调控[J].中华物理医学与康复杂志,2021,43(3):215-220
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| 小脑间歇性θ短阵脉冲刺激对健康人双侧大脑运动皮质兴奋性的调控 |
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| DOI：10.3760/cma.j.issn.0254-1424.2021.03.005 |
| 中文关键词: 间歇性θ短阵脉冲刺激 小脑 大脑运动皮质 |
| 英文关键词: Intermittent transcranial stimulation Theta-burst stimulation Cerebellum Motor cortex |
| 基金项目:国家重点研发计划（2020YFC2004202）;上海市科学技术委员会项目（20412420200，18411962300）;上海市临床重点专科项目（shslczdzk02702） |
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| 中文摘要: |
| 目的 研究小脑间歇性θ短阵脉冲刺激（iTBS）对双侧大脑运动皮质M1区兴奋性的影响及持续时间。 方法 根据刺激部位的不同，按随机数字表法将纳入的20例青年健康受试者分为左侧小脑iTBS组和右侧小脑iTBS组，每组10例。所有受试者在进行所属组别的刺激模式干预前，先测量双侧大脑M1区静息运动阈值（RMT）及运动诱发电位（MEP），于刺激后40 min内的8个时间点（5、10、15、20、25、30、35、40 min）分别测量双侧大脑M1区MEP, 并分析MEP波幅在干预前后的变化以及其随时间变化的规律。 结果 ①iTBS作用于左侧小脑可引起右侧大脑运动皮质兴奋性增高，该作用在刺激结束5～15 min内开始出现，至少可以持续到刺激后25 min（P＜0.05）。刺激后35 min的MEP较基线差异无统计学意义（P＞0.05）。②iTBS作用于左侧小脑后，左侧大脑M1区MEP波幅有下降趋势，但各时间点ΔMEP变化差异均无统计学意义（P＞0.05）。③iTBS作用于右侧小脑后，左侧大脑M1区MEP波幅有上升趋势，但各时间点ΔMEP变化差异均无统计学意义（P＞0.05）。④iTBS作用于右侧小脑后右侧大脑M1区MEP波幅有下降趋势，仅刺激后30 min时的ΔMEPN较基线差异有统计学意义（P＜0.05），其余各时间点的ΔMEP之间差异均无统计学意义（P＞0.05）。 结论 iTBS作用于小脑可引起对侧大脑运动皮质兴奋性增高，效果可维持至刺激后25 min；可使同侧大脑运动皮质兴奋性下降，且其效果可持续至少30 min。 |
| 英文摘要: |
| Objective To explore the effect of intermittent theta-burst stimulation (iTBS) of the cerebellum on the excitability of the M1 zone in the bilateral motor cortex and the duration of any effect. Methods Twenty healthy youths were randomly assigned to a left or a right cerebellum iTBS group, each of 10. The resting motor threshold and motor evoked potential (MEP) of the motor cortex were determined before giving 600 pulses of iTBS. Then MEP was measured at the 5th, 10th, 15th, 20th, 25th, 30th, 35th and 40th minute after the intervention ended. Any changes in MEP amplitude were also analyzed. Results ①The average MEP amplitude in the right motor cortex had increased significantly in the left cerebellum iTBS group from the 5th to the 15th minute. The increase lasted at least 10 minutes. Then it had returned to the baseline value at the 35th minute. ②The MEP amplitude in the left motor cortex decreased slightly after iTBS of the left cerebellum began, but there were no significant changes. ③The MEP amplitude in the left motor cortex had a tendency to decrease after iTBS was administered to the right cerebellum, but that change too was not significant. ④The MEP amplitude of the right motor cortex decreased significantly only for the first 30 minutes. Conclusions iTBS of the cerebellum can increase the excitability of the contralateral motor cortex. The effect can last 25 minutes. It can also decrease the excitability of the ipsilateral motor cortex for 30 minutes. |
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