未经证实:脊髓小脑性共济失调3型(SCA3)是最常见的常染色体显性遗传性共济失调,and,到目前为止,有效治疗仍然很低。重复经颅磁刺激(rTMS)可以改善脊髓小脑共济失调的症状,但机制尚不清楚;此外,尚未研究症状的改善是否与小脑代谢有关。因此,本研究的目的是探讨低频rTMS对SCA3患者局部小脑代谢的影响以及症状改善与小脑代谢的关系。
未经批准:双盲,prospective,随机化,在18例SCA3患者中进行了假对照试验.参与者被随机分配到真实刺激组(n=9)或假刺激组(n=9)。两组中的每位参与者都接受了30分钟的1HzrTMS刺激(总共900次脉冲),仅在刺激器放置方面不同,连续15天。为了分别比较真实组和虚假组的刺激前后数据(磁共振波谱(MRS)数据和国际合作共济失调评定量表(ICARS)评分),配对样本t检验和Wilcoxon符号秩检验用于分析。采用独立t检验和协方差分析两组间ICARS和MRS数据的差异。为了探讨小脑代谢浓度的变化与ICARS之间的关系,我们应用皮尔逊相关分析。
未经批准:治疗15天后,两组的ICARS评分均显着下降,而与假刺激组相比,真实刺激组的下降更为显着(p<0.001)。协方差分析进一步证实,与假刺激组相比,治疗后真实刺激组的总ICARS评分降低更显著(F=31.239,p<0.001)。小脑软骨NAA/Cr和Cho/Cr值,双侧齿状核,真实刺激组双侧小脑半球明显增多(p<0.05),假刺激组差异无统计学意义(p>0.05)。协方差分析也证实了真实刺激组中较大的变化。这项研究还表明,右小脑半球的NAA/Cr与真实刺激组中的ICARS之间呈负相关(r=-0.831,p=0.02)。
UNASSIGNED:发现在小脑上方使用rTMS治疗会引起SCA3患者小脑局部代谢和微环境的变化。这些改变可能有助于改善SCA3患者的共济失调症状。
UNASSIGNED: Spinocerebellar ataxia type 3 (SCA3) is the most common autosomal dominant hereditary ataxia, and, thus far, effective treatment remains low. Repetitive transcranial magnetic stimulation (rTMS) can improve the symptoms of spinal cerebellar ataxia, but the mechanism is unclear; in addition, whether any improvement in the symptoms is related to cerebellar metabolism has not yet been investigated. Therefore, the purpose of this study was to investigate the effects of low-frequency rTMS on local cerebellar metabolism in patients with SCA3 and the relationship between the improvement in the symptoms and cerebellar metabolism.
UNASSIGNED: A double-blind, prospective, randomized, sham-controlled trial was carried out among 18 SCA3 patients. The participants were randomly assigned to the real stimulation group (n = 9) or sham stimulation group (n = 9). Each participant in both the groups underwent 30 min of 1 Hz rTMS stimulation (a total of 900 pulses), differing only in terms of stimulator placement, for 15 consecutive days. To separately compare pre- and post-stimulation data (magnetic resonance spectroscopy (MRS) data and the International Cooperative Ataxia Rating Scale (ICARS) score) in the real and sham groups, paired-sample t-tests and Wilcoxon\'s signed-rank tests were used in the analyses. The differences in the ICARS and MRS data between the two groups were analyzed with independent t-tests and covariance. To explore the association between the changes in the concentration of cerebellar metabolism and ICARS, we applied Pearson\'s correlation analysis.
UNASSIGNED: After 15 days of treatment, the ICARS scores significantly decreased in both the groups, while the decrease was more significant in the real stimulation group compared to the sham stimulation group (p < 0.001). The analysis of covariance further confirmed that the total ICARS scores decreased more dramatically in the real stimulation group after treatment compared to the sham stimulation group (F = 31.239, p < 0.001). The values of NAA/Cr and Cho/Cr in the cerebellar vermis, bilateral dentate nucleus, and bilateral cerebellar hemisphere increased significantly in the real stimulation group (p < 0.05), but no significant differences were found in the sham stimulation group (p > 0.05). The analysis of covariance also confirmed the greater change in the real stimulation group. This study also demonstrated that there was a negative correlation between NAA/Cr in the right cerebellar hemisphere and ICARS in the real stimulation group (r = - 0.831, p = 0.02).
UNASSIGNED: The treatment with rTMS over the cerebellum was found to induce changes in the cerebellar local metabolism and microenvironment in the SCA3 patients. The alterations may contribute to the improvement of the symptoms of ataxia in SCA3 patients.