PDF(Pubmed)
Abstract：
BACKGROUND: In absence of drug therapy options, standard treatment for spinocerebellar ataxia consists of symptomatic physiotherapy and speech therapy. New therapeutic options are urgently needed. Transcranial magnetic stimulation is a promising therapeutic option, but applicability is limited by lengthy duration of stimulation protocols.
METHODS: In this randomized sham controlled clinical trial, patients were assigned to verum (n = 15) or sham (n = 18) cerebellar transcranial magnetic stimulation. To yield best possible treatment effects, both intervention groups received intensified physiotherapy for the duration of the study.
RESULTS: Ataxia severity was reduced by 1.6 points on the Scale for assessment and Rating of Ataxia among patients in the verum group (p < 0.001). Clinical improvement was significantly larger in the verum group, compared to the sham group (p < 0.01). The treatment effect was mainly carried by improved appendicular coordination. Patients in the verum group also significantly improved in the 8 Meter Walk Test (p < 0.05) and PATA rate (p < 0.01).
CONCLUSIONS: Cerebellar rTMS ameliorates ataxia severity in patient with spinocerebellar ataxia. Condensing treatment duration to only 5 days without reduction of treatment effects facilitates applicability and therefore broadens availability to larger patient populations.
METHODS: In this randomized sham controlled clinical trial, patients were assigned to verum (n = 15) or sham (n = 18) cerebellar transcranial magnetic stimulation. To yield best possible treatment effects, both intervention groups received intensified physiotherapy for the duration of the study.
RESULTS: Ataxia severity was reduced by 1.6 points on the Scale for assessment and Rating of Ataxia among patients in the verum group (p < 0.001). Clinical improvement was significantly larger in the verum group, compared to the sham group (p < 0.01). The treatment effect was mainly carried by improved appendicular coordination. Patients in the verum group also significantly improved in the 8 Meter Walk Test (p < 0.05) and PATA rate (p < 0.01).
CONCLUSIONS: Cerebellar rTMS ameliorates ataxia severity in patient with spinocerebellar ataxia. Condensing treatment duration to only 5 days without reduction of treatment effects facilitates applicability and therefore broadens availability to larger patient populations.
摘要：
背景：在没有药物治疗选择的情况下，脊髓小脑性共济失调的标准治疗包括对症物理治疗和言语治疗。迫切需要新的治疗选择。经颅磁刺激是一种很有前途的治疗选择,但适用性受到长时间刺激方案的限制。
方法：在这项随机假对照临床试验中，患者被分配到verum(n=15)或sham(n=18)小脑经颅磁刺激.为了产生最佳的治疗效果，在研究期间,两个干预组接受强化物理治疗.
结果：在verum组患者的共济失调评估和评级量表上，共济失调严重程度降低了1.6分（p<0.001）。Verum组的临床改善明显更大，与假手术组相比(p<0.01)。治疗效果主要通过改善阑尾协调来实现。Verum组患者的8米步行测试（p<0.05）和PATA率（p<0.01）也显着提高。
结论：小脑rTMS可改善脊髓小脑共济失调患者的共济失调严重程度。将治疗持续时间浓缩至仅5天而不降低治疗效果有利于适用性,因此扩大了对更大患者群体的可用性。
方法：在这项随机假对照临床试验中，患者被分配到verum(n=15)或sham(n=18)小脑经颅磁刺激.为了产生最佳的治疗效果，在研究期间,两个干预组接受强化物理治疗.
结果：在verum组患者的共济失调评估和评级量表上，共济失调严重程度降低了1.6分（p<0.001）。Verum组的临床改善明显更大，与假手术组相比(p<0.01)。治疗效果主要通过改善阑尾协调来实现。Verum组患者的8米步行测试（p<0.05）和PATA率（p<0.01）也显着提高。
结论：小脑rTMS可改善脊髓小脑共济失调患者的共济失调严重程度。将治疗持续时间浓缩至仅5天而不降低治疗效果有利于适用性,因此扩大了对更大患者群体的可用性。
