多靶点高频重复经颅磁刺激治疗帕金森病冻结步态的效果  

Effect of multi-target high-frequency repetitive transcranial magnetic stimulation for freezing of gait in Parkinson's disease

作　　者：陈珍[1] 张慧[1] 巩尊科[1] 赵辉[1] 李晨旭 CHEN Zhen;ZHANG Hui;GONG Zun-ke;ZHAO Hui;LI Chen-xu(Department of Neurology,Xuzhou Central Hospital,Xuzhou Jiangsu 221000,China)

机构地区：[1]徐州市中心医院神经内科,江苏徐州221000

出　　处：《局解手术学杂志》2025年第1期80-84,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：徐州市卫生健康委科技项目(XWKYHT20220163)。

摘　　要：目的 观察多靶点重复经颅磁刺激对帕金森病冻结步态的临床疗效。方法 选择2023年1月至2024年1月于我院就诊的45例帕金森病冻结步态患者,根据随机数字表法将其分为初级运动皮层(M1)治疗组(M1组)、背外侧前额叶皮层(DLPFC)组(D组)和M1+DLPFC组(MD组),每组15例。M1组患者刺激部位为双侧M1区下肢支配区,D组患者刺激部位为双侧DLPFC,MD组患者为左侧M1区和DLPFC区隔日轮流刺激。比较各组患者帕金森病冻结步态的疗效及情绪评分变化。结果 D组和MD组各有1例患者失访,最终纳入43例患者。各组患者治疗后的冻结步态量表(FOGQ)评分、“起立-行走”测试(TUGT)总时间、“站立-起始180°转身”测试(SS-180)时间、统一帕金森病运动部分评定量表(UPDRSⅢ)评分、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分均较治疗前改善(P<0.05),且MD组患者改善效果显著优于M1组和D组(P<0.05)。结论 双侧M1区和DLPFC区高频重复经颅磁刺激可改善帕金森病患者冻结步态、行走能力和运动功能,缓解抑郁焦虑症状。Objective To observe the clinical efficacy of multi-target repetitive transcranial magnetic stimulation on freezing of gait in Parkinson's disease.Methods A total of 45 Parkinson's disease patients with freezing of gait in our hospital from January 2023 to January 2024 were selected and randomly divided into primary motor cortex(M1) treatment group(M1 group),dorsolateral prefrontal cortex(DLPFC) group(D group),and M1+DLPFC group(MD group),with 15 cases in each group.The stimulation site of patients in M1 group was bilateral M1 region lower limb innervation region,the stimulation site of patients in D group was bilateral DLPFC,and the left M1 region and DLPFC region of patients in MD group were stimulated on alternate days.The efficacy of Parkinson's disease patients with freezing of gait and the changes of mood scores were compared among the groups.Results One patient in D group and one in MD group were lost to follow-up,and 43 patients were eventually included.The freezing of gait questionnaire(FOGQ) scores,timed up and go test(TUGT) total time,modified standing-start 180° turn test(SS-180) time,unified Parkinson's disease rating scale part Ⅲ(UPDRS Ⅲ) scores,Hamilton depression scale(HAMD) scores and Hamilton anxiety scale(HAMA) scores of patients after treatment were improved compared with those before treatment in all three groups(P<0.05),and the improvement effect of MD group was significantly better than those of M1 group and D group(P<0.05).Conclusion High-frequency repetitive transcranial magnetic stimulation targeting bilateral M1 region and DLPFC region can improve freezing of gait,walking ability,and motor function,and alleviate symptoms of depression and anxiety of Parkinson's disease patients.

关 键 词：帕金森病 冻结步态 重复经颅磁刺激 初级运动皮层 背外侧前额叶层 运动症状 

分 类 号：R742.5[医药卫生—神经病学与精神病学]