| 庄 敏,李浩正,李培君,金 涛,李 艳,梁 可,邓信辽,刘晓丹.间歇性θ短阵脉冲刺激对脑卒中后中重度运动功能障碍患者的即刻影响及机制研究[J].中国康复医学杂志,2023,(2):174~179 |
| 间歇性θ短阵脉冲刺激对脑卒中后中重度运动功能障碍患者的即刻影响及机制研究 点此下载全文 |
| 庄 敏 李浩正 李培君 金 涛 李 艳 梁 可 邓信辽 刘晓丹 |
| 上海中医药大学康复医学院，上海市，201203 |
| 基金项目：国家自然科学基金（82072551，81902307）；上海中医药大学研究生创新培养专项（Y2021061） |
| DOI：10.3969/j.issn.1001-1242.2023.02.006 |
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| 摘要： |
| 摘要
目的：探索间歇性θ短阵脉冲刺激（iTBS）对脑卒中后中重度运动功能障碍患者的即刻影响机制。
方法：于2020年8月—2021年3月在复旦大学附属华山医院康复医学科门诊或病房招募脑卒中患者10例，随机分为iTBS组和安慰刺激组，iTBS组接受单次患侧初级运动皮层区（primary motor cortex，M1）的iTBS干预，安慰刺激组接受单次患侧M1的安慰刺激干预。干预前后对所有患者进行神经电生理评估和近红外脑功能检测。
结果：与安慰刺激组相比，iTBS刺激组干预后功能连接强度在患侧M1区-健侧初级躯体感觉皮层区（primary somatosensory cortex，S1）和患侧M1区-健侧辅助运动皮层区（pre-motor and supplementary motor cortex，SMA）较干预前显著性升高（P<0.05）。然而，双侧M1区的MEP波幅并未发生显著性变化（P>0.05）。
结论：针对脑卒中后中重度运动功能障碍患者，单次iTBS刺激可引起大脑发生即刻的神经可塑性改变，但未能引起大脑结构或功能的显著性变化。 |
| 关键词：脑卒中 运动功能障碍 θ短阵脉冲刺激 功能性近红外光谱技术 |
| Study on the immediate effect of intermittent θ short array pulse stimulation in patients with moderate to severe motor dysfunction after stroke and underlying mechanism Download Fulltext |
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| Shanghai University of Traditional Chinese Medicine， Shanghai，201203 |
| Fund Project: |
| Abstract: |
| Abstract
Objective： To explore the mechanism of immediate effects of intermittent theta short burst stimulation （iTBS） on moderate to severe motor dysfunction after stroke.
Method： Ten stroke patients were randomly divided into iTBS group and sham stimulation group. The iTBS group received a single iTBS treatment that was applied to the primary motor cortex （M1） of the affected side， while the sham stimulation group received a single sham stimulation that was also applied to the M1 of the affected side. Before and after the treatment， neuroelectrophysiological evaluation and functional near-infrared spectroscopy examination were performed in all patients.
Result： Compared with the sham stimulation group， the iTBS stimulation group showed increased functional connectivity between right M1 and left primary somatosensory cortex （S1）， right M1 and left supplementary motor cortex （SMA） after intervention （P<0.05）. However， there was no significant change in MEP amplitude in bilateral M1 （P>0.05）.
Conclusion： For patients with moderate to severe motor dysfunction after stroke， a single iTBS stimulation could lead to immediate neuroplastic changes in the human brain， but the results might fail to reflect structural and functional brain changes. |
| Keywords:stroke motor dysfunction intermittent theta burst stimulation functional near-infrared spectroscopy |
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