高峻岭，梅元武，张振建，俞善纯，包敏.低频重复经颅磁刺激在帕金森病中的康复治疗作用[J].中华物理医学与康复杂志,2003,(11):.-
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| 低频重复经颅磁刺激在帕金森病中的康复治疗作用 |
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| DOI： |
| 中文关键词: 帕金森病 重复经颅磁刺激 康复治疗 |
| 英文关键词: Parkinson's disease Repetitive TMS Rehabilitative treatment |
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| 摘要点击次数: 1950 |
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| 中文摘要: |
| 目的探讨低频重复经颅磁刺激（rTMS）对帕金森患者的治疗效果。 方法对35例帕金森病（PD）患者予以低频rTMS治疗，以60％最大刺激强度刺激双侧额叶，每侧刺激30次，频率0.5 Hz, 每日1序列，连续治疗共7次为1个疗程。于治疗前、后观察WPDEF评分、汉密尔顿抑郁分级量表（HAMD）及中枢静止期（CSP）等指标变化，评估rTMS在PD康复及治疗中的作用。 结果低频rTMS 治疗后WPDEF评分减少(P<0.01)。TMS=CSP 延长，HAMD降低(P<0.05)，其差异具有显著性。治疗的近期总有效率为86％，远期效果有待进一步观察。 结论低频rTMS治疗在减轻PD主要临床症状的同时也能改善其伴随的抑郁状态，适用于PD的康复辅助治疗；其作用机理为低频rTMS可能增强皮质内抑制而延长CSP，促进多巴胺的释放，以及改善PD伴随的抑郁心境。 |
| 英文摘要: |
| Objective To study the therapeutic effects of low=frequency repetitive transcranial magnetic stimulation (rTMS) on patients with Parkinson's Disease (PD). MethodsThirty=five PD patients were treated with low frequency rTMS, each side of the prefrontal lobe was applied with 30 stimulations each day. The intensity is 60% of the maximum intensity, and frequency 0.5Hz. The low frequency rTMS treatment lasted for 7 consecutive days. Before and after the rTMS treatment, we evaluated the patients by use of the Webster Parkinson's Disease Evaluation Form (WPDEF), Hamilton Depression Scale (HAMD), and recorded the variables of TMS=induced motor evoked potential(MEP), which was recordedfrom the Abductor Pollicis brevis muscle. One of the variables the central silent period （CSP）is chosen to measure the change after low=frenquency rTMS since it is significantly shortened in those PD patient without any kind of therapy including those of L=Dopa. ResultsAfter the treatment of low=frequency rTMS, the patients scored significantly lower on WPDEF(P<0.05) and HAMD(P<0.05). There was a very significant prolongation of TMS=CSP(P<0.01). The total short=term efficient rate of low=frequency rTMS was 86%, yet the long=term effect of rTMS is still to be studied. ConclusionLow frequency rTMS is efficient to relieve the clinical symptoms of PD, at the same time the concomitant symptoms such as neurosis and depression also alleviated. Low=frequency rTMS may enhance the intracortical inhibition (ICI), prolong the Central Silent Period (CSP). rTMS of the prefrontal cortex may induce the release of endogenous dopamine. This experiment has implications for the therapeutic and research use of rTMS in neurological and psychiatric disorders such as PD and depression in the rehabilitative treatment. |
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