经颅和外周磁刺激治疗脑卒中后上肢运动功能障碍的随机对照研究

被引：20

作者：

俞风云 ^{[1
,2
]}

朱玉连 ^{[1
,2
]}

梁思捷 ^{[1
]}

王卫宁 ^{[1
]}

胡瑞萍 ^{[1
]}

田闪 ^{[1
]}

吴毅 ^{[1
]}

机构：

[1] 复旦大学附属华山医院康复医学科

[2] 上海体育学院运动科学学院

来源：

中国康复医学杂志 | 2021年 / 36卷 / 05期

关键词：

脑卒中; 外周磁刺激; 经颅磁刺激; 上肢运动功能障碍;

D O I：

暂无

中图分类号：

R743.3 [急性脑血管疾病（中风）];

学科分类号：

100204 [神经病学];

摘要：

目的:观察对比外周磁刺激(peripheral magnetic stimulation,PMS)和中枢磁刺激对脑卒中后中重度上肢运动功能障碍的影响。方法:共42例符合纳入标准的脑卒中患者参加试验,将所有受试者随机分为对照组(14例)、PMS组(13例)和中枢组(15例)。对照组接受常规康复治疗,PMS组在常规康复治疗的基础上接受患侧上肢Erb点的磁刺激干预,中枢组在常规康复治疗的基础上接受患侧初级运动皮层间歇性Theta节律性刺激(iTBS)。每天1次干预,每周5天,共2周。在干预前、干预结束后对受试者进行上肢Fugl-Meyer评分(UL-FMA)、改良Barthel指数(BI)、改良Ashworth量表(MAS)、简易智力状态检查量表(MMSE)的评估和双侧皮质静息运动阈值(RMT)测定。结果:42例患者均完成了10天的干预,未出现任何不良反应。磁刺激干预对脑卒中患者UL-FMA和BI的改善效果优于对照组,中枢组与对照组之间存在显著差异(P<0.05)。MAS和MMSE评分在干预前后的组间和组内比较均不存在显著性差异。多数患者患侧不能诱发MEP,能诱发MEP的患者其患侧RMT远高于健侧,组间RMT在干预前、干预后都不存在显著变化(P>0.05)。结论:与常规治疗相比,磁刺激能够促进脑卒中后中重度上肢运动功能障碍患者上肢功能的恢复和日常生活活动能力的提高,中枢磁刺激效果优于外周磁刺激。

引用

页码：538 / 545

页数：8

共 34 条

[1]

Repetitive Peripheral Magnetic Stimulation for Patients After Stroke [J].

Sakai, Kotomi ;

Yasufuku, Yuichi ;

Kamo, Tomohiko ;

Ota, Erika ;

Momosaki, Ryo .

STROKE, 2020, 51 (06) :E105-E106

[2]

Efficacy of coupling intermittent theta-burst stimulation and 1 Hz repetitive transcranial magnetic stimulation to enhance upper limb motor recovery in subacute stroke patients: A randomized controlled trial [J].

Meng, Ying ;

Zhang, Dai ;

Hai, Hong ;

Zhao, Ying-Yu ;

Ma, Yue-Wen .

RESTORATIVE NEUROLOGY AND NEUROSCIENCE, 2020, 38 (01) :109-118

[3]

Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018) [J].

Lefaucheur, Jean-Pascal ;

Aleman, Andre ;

Baeken, Chris ;

Benninger, David H. ;

Brunelin, Jerome ;

Di Lazzaro, Vincenzo ;

Filipovic, Sasa R. ;

Grefkes, Christian ;

Hasan, Alkomiet ;

Hummel, Friedhelm C. ;

Jaaskelainen, Satu K. ;

Langguth, Berthold ;

Leocani, Letizia ;

Londero, Alain ;

Nardone, Raffaele ;

Nguyen, Jean-Paul ;

Nyffeler, Thomas ;

Oliveira-Maia, Albino J. ;

Oliviero, Antonio ;

Padberg, Frank ;

Palm, Ulrich ;

Paulus, Walter ;

Poulet, Emmanuel ;

Quartarone, Angelo ;

Rachid, Fady ;

Rektorova, Irena ;

Rossi, Simone ;

Sahlsten, Hanna ;

Schecklmann, Martin ;

Szekely, David ;

Ziemann, Ulf .

CLINICAL NEUROPHYSIOLOGY, 2020, 131 (02) :474-528

[4]

Theta burst stimulation in humans: a need for better understanding effects of brain stimulation in health and disease [J].

Rounis, Elisabeth ;

Huang, Ying-Zu .

EXPERIMENTAL BRAIN RESEARCH, 2020, 238 (7-8) :1707-1714

[5]

Repetitive peripheral magnetic stimulation for impairment and disability in people after stroke..[J].Sakai Kotomi;Yasufuku Yuichi;Kamo Tomohiko;Ota Erika;Momosaki Ryo.The Cochrane database of systematic reviews.2019,

[6]

The effect and optimal parameters of repetitive transcranial magnetic stimulation on motor recovery in stroke patients: a systematic review and meta-analysis of randomized controlled trials [J].

Xiang, Huifang ;

Sun, Jing ;

Tang, Xiang ;

Zeng, Kebin ;

Wu, Xiushu .

CLINICAL REHABILITATION, 2019, 33 (05) :847-864

[7]

Short-term session of repetitive peripheral magnetic stimulation combined with motor imagery facilitates corticospinal excitability in healthy human participants [J].

Asao, Akihiko ;

Ikeda, Haruka ;

Nomura, Tomonori ;

Shibuya, Kenichi .

NEUROREPORT, 2019, 30 (08) :562-566

[8]

Individual recovery profiles of manual dexterity; and relation to corticospinal lesion load and excitability after stroke –a longitudinal pilot study.[J].Julia Birchenall;Maxime Térémetz;Pauline Roca;Jean-Charles Lamy;Catherine Oppenheim;Marc A. Maier;Jean-Louis Mas;Catherine Lamy;Jean-Claude Baron;Påvel G. Lindberg.Neurophysiologie Clinique.2019, 2

[9]

Intermittent theta burst stimulation plus external counterpulsation for upper limb motor recovery after ischemic stroke.[J].W. He;T. Leung;H. Leung;L. Wong.Brain Stimulation.2019, 2

[10]

Alterations in Motor Cortical Excitability Induced by Peripheral Stimulation With Magnetic Stimulation [J].

Sato, A. ;

Torii, T. ;

Iwahashi, M. ;

Iramina, K. .

IEEE TRANSACTIONS ON MAGNETICS, 2018, 54 (11)

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