Lasting effects of repeated rTMS application in focal hand dystonia.
Lasting effects of repeated rTMS application in focal hand dystonia.
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DOI：
10.3233/rnn-2009-0461
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发表时间：
2009
影响因子：
2.8
通讯作者：
Kimberley TJ
中科院分区：
文献类型：
--
作者：
Borich M;Arora S;Kimberley TJ
局灶性手肌张力障碍（FHD）是一种罕见的，但潜在的破坏性疾病，涉及不自主的肌肉痉挛和异常姿势，损害功能性手的使用。皮质兴奋性增加和缺乏抑制机制与这些症状有关。本研究探讨了重复经颅磁刺激（rTMS）对大脑皮层兴奋性和书写能力的短期和长期影响。研究了6名FHD受试者和9名健康对照者。所有FHD受试者连续5天接受运动前皮质（PMC）rTMS（1 Hz）;其中3例受试者接受5天假rTMS，在真实的治疗前10天完成。健康受试者接受一次真实的rTMS治疗。比较治疗前后和治疗后10天随访时的皮质沉默期（CSP）和书写性能指标。在基线时，观察到FHD受试者和健康对照者之间CSP和笔压存在显著差异。在治疗期间观察到真实的和假rTMS组受试者之间CSP和笔速度的差异，并在随访时保持差异。经过5天的rTMS到PMC后，观察到皮质兴奋性降低和手写表现改善，并在FHD受试者治疗后至少维持10天。这些初步结果支持进一步研究rTMS在FHD中的治疗潜力。
Focal hand dystonia (FHD) is a rare but potentially devastating disorder involving involuntary muscle spasms and abnormal posturing that impairs functional hand use. Increased cortical excitability and lack of inhibitory mechanisms have been associated with these symptoms. This study investigated the short- and long-term effects of repeated administrations of repetitive-transcranial magnetic stimulation (rTMS) on cortical excitability and handwriting performance. Six subjects with FHD and nine healthy controls were studied. All subjects with FHD received rTMS (1Hz) to the premotor cortex (PMC) for five consecutive days; of those, three subjects received five days of sham rTMS completed ten days prior to real treatment. Healthy subjects received one real rTMS session. Cortical silent period (CSP) and measures of handwriting performance were compared before and after treatment and at ten-day post-treatment follow-up. At baseline, significant differences in CSP and pen pressure were observed between subjects with FHD and healthy controls. Differences in CSP and pen velocity between subjects in real and sham rTMS groups were observed across treatment sessions and maintained at follow-up. After five days of rTMS to PMC, reduced cortical excitability and improved handwriting performance were observed and maintained at least ten days following treatment in subjects with FHD. These preliminary results support further investigation of the therapeutic potential of rTMS in FHD.