重复经颅磁刺激治疗脑卒中后下肢运动功能障碍的Scoping综述  

Repetitive transcranial magnetic stimulation for lower limb dysfunction post stroke:a scoping review

作　　者：黄凯琪 辛榕 凌耿强 王朴 HUANG Kaiqi;XIN Rong;LING Gengqiang;WANG Pu(Department of Rehabilitation Medicine,the Seventh Affiliated Hospital,Sun Yat-sen University,Shenzhen,Guangdong 518107,China;Brain Center,the Seventh Affiliated Hospital,Sun Yat-sen University,Shenzhen,Guangdong 518107,China)

机构地区：[1]中山大学附属第七医院康复医学科,广东深圳市518107 [2]中山大学附属第七医院神经医学中心,广东深圳市518107

出　　处：《中国康复理论与实践》2023年第3期286-293,共8页Chinese Journal of Rehabilitation Theory and Practice

基　　金：国家重点研发计划项目(No.2020YFC2004302);国家自然科学基金项目(No.U21A20479);深圳市科技研发项目(No.JCYJ20190809151007769)。

摘　　要：目的总结分析重复经颅磁刺激(rTMS)治疗脑卒中后下肢运动功能障碍的刺激方案。方法检索建库至2022年8月17日Web of Science、PubMed、中国知网、万方数据库中rTMS治疗脑卒中后下肢运动功能障碍的相关文献。采用物理治疗证据数据库(PEDro)量表对纳入文献进行质量评价。由两名研究人员筛选文献、整理资料并进行Scoping综述。结果最终纳入文献21篇,20项研究结果显示rTMS治疗有益于脑卒中后下肢运动功能障碍的恢复,1项研究结果为阴性。所有研究结果均提示rTMS治疗安全性良好,无严重不良反应。纳入研究中受试者情况、研究设计方案、刺激疗程、线圈类型及刺激部位、运动诱发电位的测定等均存在异质性。结论rTMS治疗脑卒中后下肢运动功能障碍的研究需要结合脑卒中的病程和损伤的程度来制定刺激方案。同时,需要更多同类型设计及刺激方案信息完整的真刺激对照假刺激的rTMS研究来提高其应用的证据水平。Objective To summarize and analyze the protocols of repetitive transcranial magnetic stimulation(rTMS)in the treatment of post-stroke lower limb dysfunction.Methods Literature about rTMS for lower limb dysfunction of patients post stroke were retrieved from Web of Science,PubMed,CNKI,and Wanfang Data from inception to August 17,2022.The quality of the literature was evaluated with Physiotherapy Evidence Database(PEDro)scale.Literature quality,data extraction and scoping review were performed by two researchers.Results A total of 21 studies were included,in which 20 studies suggested that rTMS treatment could promote the recovery of lower limb motor function after stroke.One study showed negative result.rTMS interventions were reported safe,with no serious adverse reactions.There were great heterogeneity in the demographic and clinical information,study protocols,stimulation parameters,coil types,targets of stimulation,and motor-evoked potential measurement in the included studies.Conclusion The future protocols of rTMS need to be combined with stroke stage and severity of injury.There is a demand for more real vs.sham rTMS studies,reporting similar designs with sufficient information,to achieve a significant level of evidence regarding the use of rTMS in post-stroke patients.

关 键 词：脑卒中 重复经颅磁刺激 下肢 运动功能 Scoping综述 

分 类 号：R743.3[医药卫生—神经病学与精神病学]