目的探讨低频重复经颅磁刺激(rTMS)对帕金森病(PD)的治疗作用.方法将45例PD患者随机分为治疗组30例,假刺激组15例.治疗组给予频率1Hz、刺激强度为110%静息阈值的 rTMS,每日1次,治疗10 d,并在治疗后1个月和3个月时随访.采用UPDRS评分、木插板试验、记时运动试验和10 m折返运动试验进行疗效评价,评价前患者停服抗PD药物至少12 h.结果治疗组治疗结束后UPDRS总分及Ⅰ、Ⅱ和Ⅲ分较治疗前均明显降低(均P﹤0.01),患者木插板所用的平均时间明显减少(P﹤0.01),记时运动1 min平均运动次数明显增加(P﹤0.01),行走速度明显增快(P﹤0.01),随访3个月仍低于治疗前(P﹤0.05).治疗后3个月生活满意度(LSIB)无明显变化,而生活质量评分(PDQ)则明显降低(P﹤0.05).假刺激组治疗前后木插板试验、记时运动试验和10 m折返运动均无明显变化.结论低频rTMS可以改善PD患者的临床症状,提高患者生活质量.
Objective To study the efficacy and safety of treating Parkinson disease （PD） by repetitive transcranial magnetic stimulation （rTMS）. Methods 45 patients with PD were randomly divided into two groups. 30 patients received rTMS therapy and 15 patients were given sham stimulation. Stimuli were delivered at an intensity of 110% of resting threshold （RT） and a frequency of 1Hz once a day for 10 days. All the patients were followed-up at 1 month and 3 months after treatment. The efficacy was assessed by UPDRS score, grooved pegboard test, timed motor test and 10m turned back test. All the patients stopped using dopaminergic drugs for at least 12h before each assessment. Results In rTMS treatment group, the UPDRS total scores, UPDRS I -IU, the mean times of grooved pegboard and 10m turned back test were significantly decreased 10 days after treatment compared with pre-treatment （all P 〈0. 01 ）, The mean motor numbers of timed motor test were significantly increased （ P 〈 0. 01 ）. Statistical differences remained 3 months later （ P 〈 0. 05 ）. The scores of LSIB did not changed obviously （ P 〉 0. 05 ） , and PDQ scores significantly decreased 3 months after treatment. In sham treatment group, there was no difference of each index between pre- and post-sham treatment. Conclusion Low frequency rTMS may improve the symptoms of the patients with PD and raise their quality of life.
Journal of Clinical Neurology
transcranial magnetic stimulation
quality of life