■关于经颅磁刺激(TMS)治疗面瘫的研究很少,也没有研究比较中枢和外周TMS治疗周围性面瘫(PFP)的疗效。
■观察中枢和外周重复经颅磁刺激(rTMS)对PFP的治疗效果和安全性。
■前瞻性招募1个月内单侧发作的周围性面瘫患者,将97例PFP患者分为外周组,中央小组,和对照组。对照组给予常规治疗(药物治疗和针刺治疗),除常规治疗外,周围组和中心组接受rTMS治疗.治疗2周后,House-Brackmann(HB)分级量表,Sunnybrook面部分级系统(SFGS),采用改良Portmann量表(MPS)对3组患者的面部肌功能进行评价。
■rTMS治疗2周后,3组的HBGS/SFGS/MPS评分均显著优于治疗前(p<0.05),和HBGS的平均变化值,SFGS,与对照组相比,外围组(p<0.001;p<0.001;p=0.003;分别)和中心组(p=0.004;p=0.003;p=0.009;分别)的参与者的MPS评分明显更高。但是HBGS的平均变化值,SFGS,治疗2周后,与中心组相比,周边组参与者的MPS评分无显著差异(p=0.254;p=0.139;p=0.736)(p>0.05).
■我们的研究表明,rTMS可以是PFP患者的安全有效的辅助治疗方法。初步研究表明,外周和中枢刺激均能有效改善面神经功能,但两个位点的功效没有显著差异。
UNASSIGNED: There are very few studies on transcranial magnetic stimulation (TMS) therapy for facial paralysis and no studies comparing the efficacy of central and peripheral TMS in the treatment of peripheral facial paralysis (PFP).
UNASSIGNED: To observe the therapeutic effect and security of central and peripheral repetitive transcranial magnetic stimulation (rTMS) on PFP.
UNASSIGNED: Patients with unilateral onset of peripheral facial paralysis within 1 month were prospectively recruited, 97 patients with PFP were divided into the peripheral group, central group, and control group. The control group was given common treatment (drug therapy and acupuncture), and the peripheral and central groups received rTMS in addition to conventional treatment. After 2 weeks of treatment, the House-Brackmann (HB) grading scale, Sunnybrook facial grading system (SFGS), and modified Portmann scale (MPS) were used to evaluate the facial muscle function of patients in the three groups.
UNASSIGNED: After 2 weeks of rTMS treatment, the HBGS/SFGS/MPS scores of the three groups were significantly better than before (p < 0.05), and the mean change values of HBGS, SFGS, and MPS scores were significantly higher in participants in Peripheral Group (p < 0.001; p < 0.001; p = 0.003; respectively) and Central Group (p = 0.004; p = 0.003; p = 0.009; respectively) than in Control Group. But the mean change values of HBGS, SFGS, and MPS scores showed no significant differences in participants in the Peripheral Group than in the Central Group (p = 0.254; p = 0.139; p = 0.736; respectively) after 2 weeks of treatment (p > 0.05).
UNASSIGNED: Our study shows that rTMS can be a safe and effective adjuvant therapy for patients with PFP. Preliminary studies have shown that both peripheral and central stimulation can effectively improve facial nerve function, but there is no significant difference in the efficacy of the two sites.