局部振动对脑梗死运动皮质的即刻与延迟效应  

The immediate and delayed effect of local vibration on motor cortex of patients with stroke

作　　者：甘兆丹 许光旭 殷稚飞 孟殿怀 王红星 GAN Zhao-dan XU Guangxu YIN Zhifei et al(Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical Uni- versity, Nanjing, Jiangsu,210029)

机构地区：[1]南京医科大学第一附属医院康复医学中心,210029

出　　处：《中国康复医学杂志》2017年第8期890-894,共5页Chinese Journal of Rehabilitation Medicine

基　　金：江苏省"333"工程科技资助项目(BRA2013O77);国家自然科学基金项目(81071604)

摘　　要：目的:明确振动对大脑皮质运动区兴奋性传导的作用。方法:将20例脑梗死患者随机分为A、B组,A组给予频率7Hz,振幅7mm的振动治疗,B组给予频率14Hz,振幅7mm的振动治疗。通过经颅磁刺激下的运动诱发电位(MEP),记录A、B两组患者在振动治疗前、后及治疗1h后大脑感觉运动皮质区的MEP皮质潜伏期及中枢运动传导时间(CMCT)。比较治疗前后MEP皮质潜伏期及CMCT的变化。结果:与振动刺激前比较,7Hz的振动刺激在治疗后即刻及1h后的MEP皮质潜伏期及CMCT虽然均有缩短趋势,但只有1h后的CMCT有显著性改善(P<0.05);而14Hz组在治疗后即刻的MEP皮质潜伏期和CMCT均有显著性差异(P<0.05),1h后CMCT也较治疗前显著改善(P<0.05)。结论:7Hz和14Hz的振动刺激可明显提高患者受损脑区兴奋性,且14Hz的振动刺激更有效。Objective： To investigate the effects of local vibration on motor cortex activity in the patients with stroke. Method： Twenty patients with stroke were randomly divided into group A（10 cases） and group B（10 cases）. Group A received low frequency local vibration treatment （7Hz, 7mm）, while group B were given high frequen- cy local vibration treatment （14Hz, 7ram）. The MEP-induced cortex latency and CMCT of these two groups were recorded before, after and 1 hour after treatment by using repetitive transcranial magnetic stimulation （rT- MS）. Comparisons were performed between pre-treatment, post-treatment or pretreatment and 1 hour after treat- ment. Result： Compared with pre-treatment, CMCT recorded 1 hour after treatment of group A was significantly low- er. However, other indexes of group A had no significant changes after treatment. MEP-induced cortex latency and CMCT of group B were reduced after local vibration treatment. However, MEP-induced cortex latency in post-treatment had no significant differences. Conclusion： Local vibration stimulation could increase the activity of damaged cerebral cortex in the patients with stroke. High-frequency local vibration was more efficient.

关 键 词：局部振动 脑梗死 运动皮质兴奋性 诱发电位 

分 类 号：R743.33[医药卫生—神经病学与精神病学]