双侧背外侧前额叶高频重复经颅磁刺激改善帕金森病患者步行能力  

High-Frequency Repetitive Transcranial Magnetic Stimulation on the Bilateraldorsolateral Prefrontal Cortex Improves Walking Function in Parkinson’s Disease

作　　者：周琳 郑亚利 于永鹏[1,2] 张淑培 

机构地区：[1]青岛大学附属威海市中心医院神经内科、于永鹏创新工作室,山东 威海 [2]潍坊医学院附属威海市中心医院神经内科,山东 威海

出　　处：《临床医学进展》2021年第8期3784-3791,共8页Advances in Clinical Medicine

摘　　要：目的:探讨双侧背外侧前额叶(dorsolateral prefrontal cortex, DLPFC)高频重复经颅磁刺激(rTMS)对帕金森病(Parkinson’s disease, PD)患者步行能力的影响。方法:选择22例PD患者为研究对象,采用随机表法分为rTMS组(11例)和对照组(11例),两组均给予抗PD药物治疗,rTMS组在此基础上给予3周(12~15次)的DLPFC高频rTMS治疗,治疗前后分别测量完成起立行走计时试验所需的平均时间(TUGT)、转弯时间(TT)、转弯步数(TS)、帕金森氏病评分量表III (UPDRS-III)等评估,观察两组PD患者治疗前后步行能力参数的差异。结果:治疗前rTMS组与对照组患者TUGT、TT、TS、UPDRS-III等参数比较,差异均无统计学意义(p 】0.05)。与组内治疗前比较,治疗后rTMS组TUGT、TT、TS、UPDRS-III值减少,差异有统计学意义(p 【0.05),对照组仅UPDRS-III评分较组内治疗前降低,差异有统计学意义(p 【0.05);治疗后rTMS组与对照组相比TUGT、TT值减少,差异有统计学意义(p 【0.05)。结论:双侧DLPFC高频rTMS治疗能够改善PD患者的步行功能。Objective: To explore the effect of cumulative high-frequency repetitive transcranial magnetic stimulation (rTMS) on bilateraldorsolateral prefrontal cortex (DLPFC) in improving the walking function of patients with Parkinson’s disease (PD). Methods: Twenty-two PD patients who enrolled into this study were randomly divided into rTMS group (11 cases) and control group (11 cases). Both groups were treated with drugs and corresponding care, and the rTMS group was given three weeks (12 to 15 times) of high-frequency DLPFC rTMS stimulation. Before and after the treatment, walking function of all patients was evaluated using the mean time completing a standard TUG task (TUGT), the Unified Parkinson’s disease rating scale part III (UPDRS-III), turning steps (TS), turning time (TT). Results: There were no significant differences between the two groups in terms of TUGT, TS, TT and UPDRS-III before the treatment (p >0.05). Compared with the pre-treatment in the group, the TUGT, TT, TS, and UPDRS-III values of the rTMS group were reduced, with statistically significant differences (p <0.05). Only UPDRS-III scores were decreased in the control group. The difference was statistically significant (p <0.05). After the treatment, significant improvements were observed only in the rTMS group (p <0.05), The TUGT and TT was significantly lower than that of the control group. Conclusion: High-frequency rTMS on the bilateral DLPFC can improve the walking ability of patients with PD.

关 键 词：帕金森病 步态功能 背外侧前额叶 经颅磁刺激 

分 类 号：R74[医药卫生—神经病学与精神病学]