重复经颅磁刺激治疗帕金森病言语障碍研究进展  

Research progress in the treatment of speech disorders in patients with Parkinson disease by repetitive transcranial magnetic stimulation

作　　者：王鸣岐 史振春[1] 苏磊[1] WANG Mingqi;SHI Zhenchun;SU Lei(Shandong Mental Health Centre,Jinan 250014,China)

机构地区：[1]山东省精神卫生中心康复治疗科,济南250014

出　　处：《中国神经精神疾病杂志》2024年第1期38-42,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：甘肃省自然科学基金(编号:21JR1RA125);兰州大学医学卓越师资团队建设与教学名师培育项目(编号:lzuyxcx-2022-205);兰州大学第二医院“萃英科技创新”计划项目(编号:CY2021-BJ-A15)。

摘　　要：帕金森病(Parkinson disease,PD)患者多数会出现言语功能障碍,严重影响生活质量。近年重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)在治疗PD患者言语障碍的临床实践中取得了新的进展。研究结果提示,将rTMS作用于初级运动皮质(primary motor cortex,M1)的口面部区域和颞上回(superior temporal gyrus,STG)可能会有效地改善PD患者的言语功能,现有研究未见报道有由rTMS引起的严重不良反应。rTMS治疗PD患者言语障碍的机制可能与rTMS可以调节言语相关大脑皮质(如M1和STG)的兴奋性和功能连接程度有关。总结来说,rTMS在PD言语障碍的治疗中取得了良好的效果,但目前研究的数量较少,未来还需要更多大规模和大样本量的随机对照试验来进一步验证和支持其效果。Up to 90%of patients with Parkinson disease(PD)experience speech disorders that seriously affect quality of life.The new progress has been made on repetitive transcranial magnetic stimulation(rTMS)in the clinical practice of treating speech disorders in patients with PD in recent years.The studies showed that applying rTMS to the orofacial region of the primary motor cortex(M1)and the superior temporal gyrus(STG)could safely and effectively improve speech function of patients with PD with no reported side effects.The underlying mechanism may relate to ability of rTMS to modulate the degree of excitability and functional connectivity in speech-associated cerebral cortices,such as M1 and STG.In conclusion,rTMS has exhibited encouraging outcomes in managing speech disorders in patients with PD.However,the number of studies is still insufficient and more large-scale randomized controlled trials with large sample sizes are needed in the future to further support the findings of this review.

关 键 词：帕金森病 言语障碍 经颅磁刺激 运动皮质 颞叶 前额叶皮质 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R741.05[医药卫生—临床医学]