重复经颅磁刺激治疗帕金森病临床疗效观察.docVIP

高频及低频重复经颅磁刺激治疗不同类型帕金森病临床疗效观察 郑秀琴，于苏文*，陈红霞，蒋建波 （解放军第102医院神经内科，江苏常州，213003） [摘要] 目的(rTMS)分别对强直型及震颤型帕金森病(PD)的治疗作用及机理。方法PD患者各分别接受高频(5Hz)及低频(0.5Hz)rTMS治疗，采用UPDRS评分、运动功能试验及运动诱发电位检查等分别评价疗效。结果rTMS治疗后UPDRS总分较治疗前均显著降低(均P 0.01)，运动功能试验明显改善(P 0.01)，运动诱发电位静息阈值明显改善(P 0.01)；37例以震颤为主要表现的PD患者经低频rTMS治疗结束后UPDRS总分较治疗前均显著降低(均P 0.01)，运动功能试验明显改善(P 0.01)，运动诱发电位静息阈值明显改善(P 0.01)。结论rTMS对PD强直型效果优于震颤型，而低频rTMS对震PD颤型效果优于强直型。 [关键词] 帕金森病；；Clinical study of treating distinguished type of Parkinson’s disease by high and low frequency repetitive transcranial magnetic stimulation Zheng Xiuqin, Yu Suwen ,Chen Hongxia, Jiang Jian-bo, 102th Hospital of PLA, Changzhou Jiangsu China, 213003 [Abstract] Object: To investigate the therapeutic effects of high and low frequency repetitive transcranial magnetic stimulation(rTMS) in the rigidity and tremor patients with Parkinson’S disease(PD)．Methods: 85 patients with PD received 5Hz and 0.5Hz rTMS therapy. The efficacy was assessed by UPDRS score , motor functionand test and motor evoked potentials (MEP). Results: 32 rigidity patients with PD received 5Hz rTMS therapy, the UPDRS total scores were significantly decreased ( P0.01). The motor functionand test were significantly improved (P0.01). MEP relaxed motor threshold was elevated (P0. 01). 37 tremor patients with PD received 0.5Hz rTMS therapy, the UPDRS total scores were significantly decreased ( P0.01). The motor functionand test were significantly improved (P0.01). MEP relaxed motor threshold was elevated (P0. 01). Conclusion: High frequency rTMS may improve the symptoms of the rigidity patients with PD and low frequency rTMS may improve the symptoms of the tremor patients with PD. [Keyword] PD；rTMS； 帕金森病(Parkinson’s disease，PD) )是由于黑质多巴胺能神经元数目减少导致的运动障碍疾病，多巴胺替代疗法是药物有效治疗PD的基石，但随着病程进展逐渐衰退，部分患者对多巴胺治疗不能耐受[1]。重复经颅磁刺激(repetitive transcranial magnetic stimulation，rTMS)方法是近来用于神经康复治疗的一种技术，其作为一种非侵袭性的神经调控方法，可在了解个体症状及神经病理生理的基础上，通过合理、选择性地调控大脑皮质某些区域的功能，达到治疗的目的。本研究通过观察高频(5Hz)及低频(0.5Hz)rTMS分别治疗强直型及震颤型