目的:评估国际10-20系统P3点(顶内沟区域)的兴奋性重复经颅磁刺激(rTMS)对慢性患者的影响。通过Fugl-Meyer评估(FMA)测量的上(UL)和下肢(LL)受损。
方法:3名患者(C1:49.83/2.75,C2:53.17/3.83,C3:63.33/3.08岁卒中/卒中后年,分别)在P3的10Hz下接受了两周(五天/周)的rTMS。患者在类似条件下用假线圈治疗(S1:56.58/4.33)。之前对患者进行了评估,之后,和治疗后两个月(分别为A1,A2和A3)。
结果:对于LL,C1和C3的运动功能小节得分以及C2的感觉功能得分增加A2,并保持A3。对于UL,C2和C3的运动功能得分也增加,但C3评分下降A3。通过两次后续评估,C3的活动范围子部分的得分增加了。
结论:这项研究表明,超过P3的兴奋性rTMS可能对一些慢性中风患者有用,但这些发现需要在未来的临床试验中得到验证.
OBJECTIVE: To evaluate the effects of excitatory repetitive transcranial magnetic stimulation (rTMS) of the international 10⁻20 system P3 point (intraparietal sulcus region) in chronic patients with a frontal lesion and parietal sparing due to stroke on the impaired upper (UL) and lower limb (LL) as measured by the Fugl-Meyer Assessment (FMA).
METHODS: Three patients (C1: 49.83/2.75, C2: 53.17/3.83, C3: 63.33/3.08-years-old at stroke/years post-stroke, respectively) received two weeks (five days/week) of rTMS at 10 Hz of P3. A patient was treated in similar conditions with a sham coil (S1: 56.58/4.33). Patients were evaluated before, after, and two months post-treatment (A1, A2, and A3, respectively).
RESULTS: For LL, the scores of the motor function subsection of C1 and C3 as well as the sensory function of C2 increased by A2 and remained by A3. For UL, the score of the motor function of C2 and C3 also increased, but the score of C3 decreased by A3. The score of the range of motion subsection of C3 increased by the two follow-up evaluations.
CONCLUSIONS: This study suggests excitatory rTMS over P3 may be of use for some chronic stroke patients, but these findings need to be verified in a future clinical trial.