经颅磁刺激对健康受试者舌骨上肌群运动诱发电位的影响  

The effect of transcranial magnetic stimulation on the motor-evoked potentials of the suprahyoid muscles

作　　者：江力生 张婷[2] 林国桢[2] 李洁[2] 林拓[3] 窦祖林[1] 兰月[3] 

机构地区：[1]中山大学附属第三医院康复医学科,广州510630 [2]中山大学2011级临床医学系 [3]广州医科大学附属市第一人民医院康复医学科

出　　处：《中华物理医学与康复杂志》2015年第12期904-907,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：基金项目：国家自然科学基金面上项目（81371441）;广东省科技计划项目（20138051000036,20148020212001）

摘　　要：目的研究短阵快速脉冲经颅磁刺激（TBS）对舌骨上肌群运动皮质兴奋性的影响，进一步探讨双侧大脑半球运动皮质对舌骨上肌群的调控机制。方法选取健康受试者24例，采用持续短阵快速脉冲经颅磁刺激（cTBS）刺激受试者左侧舌骨上肌群运动皮质，采用间隔短阵快速脉冲经颅磁刺激（iTBS）刺激受试者右侧舌骨上肌群运动皮质，记录刺激前及刺激后即刻、15min、30min双侧舌骨上肌群的运动诱发电位（MEP），用重复测量方差分析方法分析刺激前、后不同时间点双侧舌骨上肌群MEP波幅的变化。结果刺激前，左右两侧舌骨上肌群MEP波幅分别为（375．29±176．09）μV和（368．17±149．02）μV，分别与同侧刺激后即刻、刺激后15min和刺激后30min舌骨上肌群MEP波幅比较，差异均有统计学意义（P〈0．05）。结论iTBS可兴奋右侧舌骨上肌群运动皮质，并能逆转左侧相应皮质被cTBS预处理的抑制效应。TBS可以影响两侧大脑半球舌骨上肌群运动皮质的兴奋性，对脑卒中后吞咽障碍患者的康复具有重要指导意义。[ Abstract] Objective To explore the effect of theta-burst stimulation （TBS） of the motor cortex on the su- prahyoid muscles and the mechanism through which the bilateral motor cortex regulates the suprahyoid muscles. Methods Continuous TBS （cTBS） was applied to the left motor cortex followed by intermittent TBS （iTBS） applied to the right motor cortex of 24 healthy subjects. The motor-evoked potentials （MEPs） of the suprahyoid muscles on both sides were recorded before the stimulation and after 15 and 30 minutes. The MEP amplitudes of the left and right suprahyoid muscles were analyzed using repeated measures analysis of variance. Results Before stimulation, the average MEP amplitudes of the left and right suprahyoid muscles were （375.29 ± 176.09 ） μV and （368. 17 ± 149.02） μV respectively, significantly lower than the values after the stimulation. Conclusion iTBS can distinctly enhance the excitability of the right motor cortex controlling the suprahyoid muscles and reverse the inhibition caused by cTBS applied to the left motor cortex. Clarifying the effect of TBS on the excitability of the bilateral motor cortex is important for the rehabilitation of dysphagic stroke survivors.

关 键 词：经颅磁刺激 舌骨上肌群 运动诱发电位 

分 类 号：R[医药卫生]