运动前区高频重复经颅磁刺激对脑卒中上肢功能康复的疗效  

Effects of High-frequency Repetitive Transcranial Magnetic Stimulation to Premotor Areas on Upper Limb Motor Dysfunction after Stroke

作　　者：周哲 沈夏锋 熊莉 张雯 黄鸿雁 张萍 吴毅 荣积峰 ZHOU Zhe;SHEN Xia-feng;XIONG Li;ZHANG Wen;HUANG Hong-yan;ZHANG Ping;WU Yi;RONG Ji-feng(Department of Rehabilitation Medicine,The First Rehabilitation Hospital of Shanghai,Shanghai 200090,China;Department of Neurological Rehabilitation,The First Rehabilitation Hospital of Shanghai,Shanghai 200090,China;Rehabilitation Treatment Center,The First Rehabilitation Hospital of Shanghai,Shanghai 200090,China;Department of Rehabilitation,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]上海市第一康复医院综合康复科,上海市200090 [2]上海市第一康复医院神经康复科,上海市200090 [3]上海市第一康复医院康复治疗中心,上海市200090 [4]复旦大学附属华山医院康复医学科,上海市200040

出　　处：《中国康复理论与实践》2020年第6期697-702,共6页Chinese Journal of Rehabilitation Theory and Practice

基　　金：上海市卫生和计划生育委员会科研项目(No.201840237);上海市残疾人联合会科研项目(No.K2018012);上海市卫生健康委员会科研项目(No.201940392)。

摘　　要：目的探讨运动前区高频重复经颅磁刺激(rTMS)对脑卒中偏瘫患者上肢运动功能恢复的影响。方法2018年8月至2019年7月,60例脑卒中偏瘫患者随机分为对照组(n=30)和观察组(n=30)。两组均进行常规药物治疗及康复训练,观察组给予患侧大脑半球运动前区5 Hz rTMS,共3周。对照组给予伪刺激。治疗前后采用Fugl-Meyer评定量表上肢部分(FMA-UE)、Brunnstrom分期、改良Ashworth量表(MAS)、改良Barthel指数(MBI)和Wolf手功能量表进行评价。结果对照组脱落2例。治疗后,两组FMA-UE、MBI和Wolf手功能量表评分均明显改善(|t|>3.686,P<0.01),观察组治疗前后FMA-UE评分和Wolf手功能量表评分差值大于对照组(|t|>2.119,P<0.05)。结论患侧大脑半球运动前区高频rTMS能促进脑卒中偏瘫患者上肢和手的运动功能恢复。Objective To explore the effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)on upper limb motor function in hemiplegic patients after stroke.Methods From August,2018 to July,2019,60 patients with hemiplegia after stroke were randomly divided into control group(n=30)and observation group(n=30).Both groups received conventional treatment.The observation group accepted 5 Hz rTMS to ipsilesional hemisphere premotor areas for three weeks.The control group received sham stimulation.They were assessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Brunnstrom stages,modified Ashworth Scale(MAS),modified Barthel Index(MBI)and Wolf Motor Function Test before and after treatment.Results Two patients dropped in the control group.After treatment,the scores of FMA-UE,MBI and Wolf Motor Function Test improved in both groups(|t|>3.686,P<0.01),and the difference values of FMA-UE and Wolf Motor Function Test before and after treatment were more in the observation group than in the control group(|t|>2.119,P<0.05).Conclusion High-frequency rTMS to ipsilesional hemisphere premotor areas could improve the recovery of upper limb and hand motor function in hemiplegic patients after stroke.

关 键 词：脑卒中 重复经颅磁刺激 运动前区 上肢 手功能 康复 

分 类 号：R743.3[医药卫生—神经病学与精神病学]