PDF(Pubmed)
Abstract：
UNASSIGNED: To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on phantom limb pain (PLP) in amputees, and to compare the therapeutic effect with that of mirror therapy (MT).
UNASSIGNED: The study was designed as a randomized controlled trial. The evaluators were blinded, while the subjects and the therapists were unblinded. Subjects were randomly assigned to either the rTMS group or the MT group with a computer-generated random number table. From June 2018 to December 2020, from out of 45 amputee patients screened for the study, 30 who met the inclusion criteria were recruited for the study. All patients were recruited from the Rehabilitation Medicine Center, West China Hospital, Sichuan University. In the end, 4 patients withdrew from the study and 26 patients (12 in the rTMS group and 14 in the MT group) completed the prescribed treatment and evaluation. The rTMS group was given rTMS (1 Hz, 15 min, 5 d/week) for 2 weeks in addition to conventional rehabilitation therapy, while the MT group received MT (corresponding movements of limbs, 15 min, 5 d/week) for 2 weeks in addition to conventional rehabilitation therapy. PLP was evaluated by the Visual Analogue Scale (VAS) and Douleur Neuropathique 4 Questions (DN-4). Subjects were assessed before treatment ( t 0), immediately after the completion of the treatment ( t 1) and 3 months after the completion of the treatment ( t 2).
UNASSIGNED: The mean age of the 26 patients was 39.73±12.64. There were 15 males and 11 females. According to the reported description of the characteristics of the PLP by the patients, the characteristics with the highest incidence were tingling, stabbing, numbing, electric shocks and burning in descending order. There was no significant difference in the incidence of PLP characteristics between the two groups ( P>0.05). The two groups had comparable baseline data, showing no significant difference in VAS and DN-4 between the two groups at t 0 ( P>0.05). At t 1 and t 2, the VAS and DN-4 scores were decreased from those of t 0, showing statistically significant difference in both groups ( P<0.01 for both scores). In the rTMS group, there was no significant difference between VAS and DN-4 scores at t 1 and those at t 2 ( P>0.05). In the MT group, the VAS and DN-4 scores at t 2 were significantly lower than those of t 1 ( P<0.05). There was no statistically significant difference between the rTMS group and MT group in the changes in pain measurements, i.e., VAS and DN-4 scores, before and after the intervention ( P>0.05). The 26 patients who completed the experiment showed no dizziness, headache, or other abnormalities during the study.
UNASSIGNED: The results of this study indicate that repetitive transcranial magnetic stimulation could improve PLP in amputees, and the improvement effect was comparable to that of mirror therapy.
UNASSIGNED: The study was designed as a randomized controlled trial. The evaluators were blinded, while the subjects and the therapists were unblinded. Subjects were randomly assigned to either the rTMS group or the MT group with a computer-generated random number table. From June 2018 to December 2020, from out of 45 amputee patients screened for the study, 30 who met the inclusion criteria were recruited for the study. All patients were recruited from the Rehabilitation Medicine Center, West China Hospital, Sichuan University. In the end, 4 patients withdrew from the study and 26 patients (12 in the rTMS group and 14 in the MT group) completed the prescribed treatment and evaluation. The rTMS group was given rTMS (1 Hz, 15 min, 5 d/week) for 2 weeks in addition to conventional rehabilitation therapy, while the MT group received MT (corresponding movements of limbs, 15 min, 5 d/week) for 2 weeks in addition to conventional rehabilitation therapy. PLP was evaluated by the Visual Analogue Scale (VAS) and Douleur Neuropathique 4 Questions (DN-4). Subjects were assessed before treatment ( t 0), immediately after the completion of the treatment ( t 1) and 3 months after the completion of the treatment ( t 2).
UNASSIGNED: The mean age of the 26 patients was 39.73±12.64. There were 15 males and 11 females. According to the reported description of the characteristics of the PLP by the patients, the characteristics with the highest incidence were tingling, stabbing, numbing, electric shocks and burning in descending order. There was no significant difference in the incidence of PLP characteristics between the two groups ( P>0.05). The two groups had comparable baseline data, showing no significant difference in VAS and DN-4 between the two groups at t 0 ( P>0.05). At t 1 and t 2, the VAS and DN-4 scores were decreased from those of t 0, showing statistically significant difference in both groups ( P<0.01 for both scores). In the rTMS group, there was no significant difference between VAS and DN-4 scores at t 1 and those at t 2 ( P>0.05). In the MT group, the VAS and DN-4 scores at t 2 were significantly lower than those of t 1 ( P<0.05). There was no statistically significant difference between the rTMS group and MT group in the changes in pain measurements, i.e., VAS and DN-4 scores, before and after the intervention ( P>0.05). The 26 patients who completed the experiment showed no dizziness, headache, or other abnormalities during the study.
UNASSIGNED: The results of this study indicate that repetitive transcranial magnetic stimulation could improve PLP in amputees, and the improvement effect was comparable to that of mirror therapy.
摘要：
■为了研究重复经颅磁刺激（rTMS）对截肢者幻肢痛（PLP）的影响，并与镜像疗法（MT）的治疗效果进行比较。
■该研究设计为随机对照试验。评估人员失明了，而受试者和治疗师是不失明的。使用计算机生成的随机数表将受试者随机分配到rTMS组或MT组。从2018年6月到2020年12月，从45名接受研究筛查的截肢患者中，招募30名符合纳入标准的人进行研究。所有患者均来自康复医学中心，华西医院,四川大学。最后,4名患者退出研究，26名患者（rTMS组12名，MT组14名）完成了规定的治疗和评估。rTMS组给予rTMS(1Hz,15分钟,5d/周)除常规康复治疗外，为期2周，而MT组接受MT(相应的四肢运动，15分钟,5d/周），除常规康复治疗外，为期2周。通过视觉模拟评分（VAS）和DouleurNeuropathique4问题（DN-4）评估PLP。受试者在治疗前进行评估（t0），治疗完成后立即（t1）和治疗完成后3个月（t2）。
■26例患者的平均年龄为39.73±12.64。有15名男性和11名女性。根据患者对PLP特征的报告描述，发病率最高的特征是刺痛，刺伤,麻木,电击和燃烧降序。两组PLP特点发生率比较差异无统计学意义(P>0.05)。两组具有可比性的基线数据，两组在t0时的VAS和DN-4差异无统计学意义（P>0.05）。在t1和t2时，VAS和DN-4评分均较t0降低，两组比较差异均有统计学意义（P<0.01）。在rTMS组中，在t1和t2时，VAS和DN-4评分之间没有显着差异（P>0.05）。在MT组中，t2时的VAS和DN-4评分明显低于t1(P<0.05)。rTMS组与MT组疼痛测量值的变化无统计学意义,即，VAS和DN-4评分，干预前后(P>0.05)。完成实验的26名患者没有出现头晕,头痛,或研究期间的其他异常。
■这项研究的结果表明，重复经颅磁刺激可以改善截肢者的PLP，改善效果与镜像疗法相当。
■该研究设计为随机对照试验。评估人员失明了，而受试者和治疗师是不失明的。使用计算机生成的随机数表将受试者随机分配到rTMS组或MT组。从2018年6月到2020年12月，从45名接受研究筛查的截肢患者中，招募30名符合纳入标准的人进行研究。所有患者均来自康复医学中心，华西医院,四川大学。最后,4名患者退出研究，26名患者（rTMS组12名，MT组14名）完成了规定的治疗和评估。rTMS组给予rTMS(1Hz,15分钟,5d/周)除常规康复治疗外，为期2周，而MT组接受MT(相应的四肢运动，15分钟,5d/周），除常规康复治疗外，为期2周。通过视觉模拟评分（VAS）和DouleurNeuropathique4问题（DN-4）评估PLP。受试者在治疗前进行评估（t0），治疗完成后立即（t1）和治疗完成后3个月（t2）。
■26例患者的平均年龄为39.73±12.64。有15名男性和11名女性。根据患者对PLP特征的报告描述，发病率最高的特征是刺痛，刺伤,麻木,电击和燃烧降序。两组PLP特点发生率比较差异无统计学意义(P>0.05)。两组具有可比性的基线数据，两组在t0时的VAS和DN-4差异无统计学意义（P>0.05）。在t1和t2时，VAS和DN-4评分均较t0降低，两组比较差异均有统计学意义（P<0.01）。在rTMS组中，在t1和t2时，VAS和DN-4评分之间没有显着差异（P>0.05）。在MT组中，t2时的VAS和DN-4评分明显低于t1(P<0.05)。rTMS组与MT组疼痛测量值的变化无统计学意义,即，VAS和DN-4评分，干预前后(P>0.05)。完成实验的26名患者没有出现头晕,头痛,或研究期间的其他异常。
■这项研究的结果表明，重复经颅磁刺激可以改善截肢者的PLP，改善效果与镜像疗法相当。
