Transcranial Magnetic Stimulation Promotes Gait Training in Parkinson Disease.
Transcranial Magnetic Stimulation Promotes Gait Training in Parkinson Disease.
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DOI：
10.1002/ana.25881
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发表时间：
2020-11
影响因子：
11.2
通讯作者：
Hallett M
中科院分区：
文献类型：
--
作者：
Chung CL;Mak MK;Hallett M
确定1或25 Hz重复经颅磁刺激（rTMS）启动是否会增强帕金森病（PD）患者干预后3个月的跑步机训练的益处，并评估皮质兴奋性的潜在变化。这项随机、双盲、安慰剂对照试验于2016年10月至2018年12月进行。51名PD参与者随机接受12次rTMS（25 Hz，1 Hz或假），然后进行跑步机训练。所有参与者在基线和干预后1天，1个月和3个月进行评估。主要结果是最快步行速度，次要结果是定时起立行走试验（TUG），双任务TUG（DT-TUG），运动障碍协会统一帕金森病评定量表（MDS-MRS-III）的运动部分，以及TMS对皮层兴奋性的电生理学评价。1和25 Hz rTMS组在干预后1天和3个月的最快步行速度比假手术组有更大的改善。只有1和25 Hz rTMS组在TUG中持续改善，并且在DT-TUG和MDS-MRS-III中有长达3个月的显著改善。在接受真实的rTMS的两组中，行为改善与皮质沉默期增加和短间隔皮质内抑制相关。1和25 Hz rTMS的启动可以增加跑步机训练的益处，并导致干预后3个月的长期运动改善。在后续的运动改善与皮质兴奋性的正常化，这反过来又表明改变的稳态可塑性范围。通过rTMS重新平衡皮质兴奋性似乎对可塑性诱导至关重要。
To determine whether priming with 1 or 25Hz repetitive transcranial magnetic stimulation (rTMS) will enhance the benefits from treadmill training up to 3 months postintervention in people with Parkinson disease (PD), and to evaluate the underlying changes in cortical excitability. This randomized double-blind, placebo-controlled trial was conducted between October 2016 and December 2018. Fifty-one participants with PD were randomized to receive 12 sessions of rTMS (25Hz, 1Hz, or sham) followed by treadmill training. All participants were assessed at baseline and 1 day, 1 month, and 3 months postintervention. Primary outcome was fastest walking speed, and secondary outcomes were timed up-and-go test (TUG), dual-task TUG (DT-TUG), motor section of the Movement Disorder Society–Unified Parkinson’s Disease Rating Scale (MDS-UPDRS-III), and electrophysiological evaluation of cortical excitability by TMS. The 1 and 25Hz rTMS groups produced a greater improvement in fastest walking speed at 1 day and 3 months postintervention than the sham group. Only the 1 and 25Hz rTMS groups sustained the improvements in TUG, and had a significant improvement in DT-TUG and MDS-UPDRS-III for up to 3 months. Behavioral improvements correlated with increased cortical silent period and short-interval intracortical inhibition in both groups receiving real rTMS. Priming with 1 and 25Hz rTMS can augment the benefits of treadmill training and lead to long-term motor improvement up to 3 months postintervention. The motor improvement at follow-up was associated with a normalization of cortical excitability, which in turn suggests an alteration of the homeostatic plasticity range. Rebalancing cortical excitability by rTMS appears critical for plasticity induction.
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DOI：
10.1111/j.1532-5415.2007.01413.x
发表时间：
2007-11-01
影响因子：
6.3
作者：
Hardy, Susan E.;Perera, Subashan;Studenski, Stephanie A.
通讯作者：
Studenski, Stephanie A.
DOI：
10.1073/pnas.0502762102
发表时间：
2005-08-30
影响因子：
11.1
作者：
Lehéricy, S;Benali, H;Doyon, J
通讯作者：
Doyon, J
影响因子：
4.7
作者：
Lefaucheur, JP;Drouot, X;Nguyen, JP
通讯作者：
Nguyen, JP
影响因子：
4.1
作者：
Nieuwboer, Alice;Rochester, Lynn;Swinnen, Stephan P.
通讯作者：
Swinnen, Stephan P.
影响因子：
5.2
作者：
Khedr, Eman M.;Al-Fawal, Bastawy;Rothwell, John C.
通讯作者：
Rothwell, John C.