低频重复经颅磁刺激对脑梗死失语的治疗作用及其对脑电活动的影响  

Therapeutical effect of low-frequency repetitive transcranial magnetic stimulation on cerebral infarction aphasia and its effect on brain electrical activity

作　　者：陈芳[1] 王晓明[2] 孙祥荣[2] 柯莎[2] 王寅旭[2] 赵晓琼[2] 黄慧[2] 胡建秀[2] 

机构地区：[1]川北医学院 [2]川北医学院附属医院神经内科

出　　处：《中华脑血管病杂志（电子版）》2011年第2期7-10,共4页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

摘　　要：目的观察低频重复经颅磁刺激(low-rTMS)对脑梗死失语的治疗作用和其对脑电活动的影响。方法选取左半球脑梗死后运动性失语右利手的患者15例,经ABC失语检查表评定后随机分为对照组7例和治疗组8例。对照组予常规药物和语言康复治疗;治疗组在对照组治疗基础上予low-rTMS治疗。rTMS治疗方法:频率1Hz、强度为运动阈值80%、部位为右侧大脑半球Broca区、每序列50次脉冲、每天10个序列、序列间隔120s,共10d。两组在治疗前和治疗后(rTMS治疗后2周)均行ABC评分和脑电非线性分析检测。结果两组治疗前的ABC评分值和脑电非线性分析参数均值(D2、PD2、Cx、LE、KE、ApEn)差异无统计学意义(P>0.05);治疗后治疗组的ABC评分和右额区脑电非线性分析参数PD2、Cx、均值比对照组显著增加,差异有统计学意义(P<0.05);而治疗组的左额区脑电非线性分析参数PD2、Cx、均值与对照组比较差异无统计学意义(P>0.05)。结论 low-rTMS刺激右侧大脑半球(Broca区)对左半球脑梗死失语患者的语言有一定的康复作用。Objective To observe the therapeutical effect of low-frequency repetitive transcranial magnetic stimulation （rTMS） on cerebral infarction aphasia and its effect on brain electrical activity. Methods 15 dextromanual patients suffering from Broca＇ s aphasia （by ABC aphasia checklist assessment） post cerebral infarction （left hemisphere） were randomly divided into two groups. The control group 7 cases accepted conventional drugs and language rehabilitation, while the treatment group 8 cases are given low-rTMS treatment after that conventional rehabilitation. Low-rTMS treatment means： give Broca area of the right side cerebrum 10 pulse sequence stimulus a day for 10 d continuously, with sequence interval equals 120 s, and each sequence consists 50 pulses whose frequency equals 1 Hz, and stimulus intensity equals 80% of the motor evoked potential threshold. Take ABC aphasia checklist assessment and non-linear EEG detection and analysis for both groups before and after the treatments （for rTMS, 2 weeks after the treatment）. Results Before treatments, the two groups＇ ABC mean score and non-linear analysis parameters （D2 , PD2, LE, KE, Cx, ApEn） had no significant difference （P 〉 0.05）. After treatments, the treatment group＇ s ABC mean score, and PD2, Cx value and mean value of non-llnear analysis for right frontal area both increased siguificantIy （ P 〈 0.05 ） , while PD2 , Cx value and mean value for left frontal area had no significant difference （ P 〉 0.05 ）. Conclusions Low-rTMS stimulation in right hemisphere （ Broca area）has certain rehabilitation effect for left hemisphere cerebral infarction aphasia patients.

关 键 词：低频重复经颅磁刺激 脑梗死 失语 脑电 

分 类 号：R743.3[医药卫生—神经病学与精神病学]