Low-frequency repetitive TMS of premotor cortex can reduce painful axial spasms in generalized secondary dystonia:: a pilot study of three patients
Low-frequency repetitive TMS of premotor cortex can reduce painful axial spasms in generalized secondary dystonia:: a pilot study of three patients
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DOI：
10.1016/j.neucli.2004.07.003
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发表时间：
2004-10-01
影响因子：
3
通讯作者：
Nguyen, JP
中科院分区：
文献类型：
--
作者：
Lefaucheur, JP;Fénelon, G;Nguyen, JP
肌张力障碍与皮质脊髓运动输出过多有关。低频重复经颅磁刺激（rTMS）可降低运动前皮层的兴奋性。在一项开放的先导研究中，我们报告了在左侧运动前皮质静息运动阈值的90%处应用1hz rTMS的效果，该研究对三名患有严重、全身性、继发性肌张力障碍的患者进行了研究，包括近端和轴端肌肉组织的疼痛性痉挛。连续5天，每天进行20分钟的运动前rTMS。在最后一次治疗后的3-8天内，rTMS系列治疗显著减少了疼痛性痉挛，没有任何其他显著的有益效果。然而，两名患者的Burke， Fahn和Marsden评定量表的运动评分略有下降，第三名患者的残疾评分略有下降。运动前皮质的低频rTMS可能改善严重的全身性肌张力障碍的某些特定运动症状。这些结果应该在更大规模的安慰剂对照研究中得到证实。(C) 2004 Elsevier SAS。版权所有。
Dystonia is associated with excessive corticospinal motor output. Motor cortex excitability may be reduced by tow-frequency repetitive transcranial magnetic stimutation (rTMS) of premotor cortical areas. We report the effects of 1 Hz rTMS applied at 90% of resting motor threshold over the left premotor cortex in an open pilot study of three patients with severe, generalized, secondary dystonia including painful spasms in the proximal and axial musculature. A 20-min session of premotor rTMS was daily performed during 5 consecutive days. The series of rTMS sessions dramatically reduced the painful spasms, for 3-8 days after the last session, without any other significant beneficial effects. However, a slight reduction of the Movement score of the Burke, Fahn and Marsden rating scale was observed for two patients, and of the Disability score for the third one. Low-frequency rTMS of the premotor cortex may improve some specific motor symptoms in severe, generalized dystonia. These results should prompt confirmation in a larger placebo-controlled study. (C) 2004 Elsevier SAS. All rights reserved.