基于TBS模式的重复经颅磁刺激联合虚拟现实治疗脑卒中单侧空间忽略的效果观察  

Effects of repetitive transcranial magnetic stimulation based on theta burst stimulation model combined with virtual reality on unilateral spatial neglect of stroke

作　　者：陶林花 曾明 任志彬 李亮 傅建明 赵慧红 TAO Linhua;ZENG Ming;REN Zhibin;LI Liang;FU Jianming;ZHAO Huihong(Department of Rehabilitation Medical Center,Jiaxing Second Hospital,Jiaxing 314000,China;不详)

机构地区：[1]嘉兴市第二医院康复医学中心,314000 [2]嘉兴市王店人民医院针灸理疗科

出　　处：《浙江医学》2024年第6期630-633,642,共5页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2022KY385)。

摘　　要：目的探讨基于θ波爆发刺激(TBS)模式的重复经颅磁刺激(rTMS)联合虚拟现实治疗脑卒中后单侧空间忽略(USN)的效果。方法选择2021年6月至2022年6月嘉兴市第二医院康复医学中心收治的脑卒中USN患者60例,按随机数字表法分为观察组和对照组,每组30例。两组患者均给予常规药物、周围环境调整、USN宣教、针对USN的行为学治疗及虚拟现实治疗,观察组在上述治疗基础上再接受基于TBS模式的rTMS。分别于治疗前、治疗4周后采用线段消切试验、字母涂抹试验、二分线试验、临摹画图试验、凯瑟琳·伯格戈量表(CBS)、简易精神状态检查量表(MMSE)、改良Barthel指数(MBI)对两组患者的USN程度、行为学、认知功能和日常生活活动能力进行评估。结果两组患者治疗后的USN程度4项试验均优于治疗前,且观察组优于对照组,差异均有统计学意义(均P<0.01)。治疗后两组患者的CBS、MMSE及MBI评估指标均优于治疗前,且观察组优于对照组,差异均有统计学意义(均P<0.01)。结论基于TBS模式的rTMS联合虚拟现实治疗可有效缓解脑卒中患者的USN程度,改善其行为表现,同时可提高患者的认知功能及日常生活活动能力,其治疗效果优于单纯虚拟现实治疗。Objective To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)based on theta burst stimulation(TBS)model combined with virtual reality on unilateral spatial neglect(USN)after stroke.Methods A total of 60 stroke patients with USN admitted to Rehabilitation Medical Center of Jiaxing Second Hospital from June 2021 to June 2022 were selected and divided into observation group and control group according to random number table method,with 30 cases in each group.Both groups were given conventional medication,ambient adjustment,USN education,behavioral therapy for USN and virtual reality therapy,and additionally,the observation group received rTMS based on TBS model.USN degree,behavior,cognitive function and activities of daily living were evaluated before and 4 weeks after treatment by the Albert test,single letter cancellation test,line bisection test,figure copy test,Catherine Bergego scale(CBS),Mini-mental state examination(MMSE)and modified Barthel index(MBI).Results After treatment,the USN degrees of the two groups were both better than those before treatment in all four tests,and the observation group was better than the control group,with the differences statistically significant(all P<0.01).After treatment,the CBS,MMSE and MBI in both groups were better than those before treatment,and the observation group was better than the control group,the differences of which were statistically significant(all P<0.01).Conclusion rTMS based on TBS model combined with virtual reality therapy can effectively alleviate the USN degree of stroke patients,improve their behavioral performance,and improve their cognitive function and activities of daily living;its therapeutic effect is better than that of virtual reality therapy alone.

关 键 词：重复经颅磁刺激 虚拟现实 脑卒中 单侧空间忽略 

分 类 号：R743.3[医药卫生—神经病学与精神病学]