Transcranial magnetic brain stimulation modulates blepharospasm
Transcranial magnetic brain stimulation modulates blepharospasm
复制标题
经颅磁脑刺激调节眼睑痉挛
作者：
G. Kranz;E. Shamim;P. Lin;G. Kranz;M. Hallett
背景：良性特发性眼睑痉挛（BEB）是局灶性肌张力障碍的常见形式。除了基底神经节的病理变化外，越来越多的证据表明前扣带皮层（ACC）也存在病理变化。方法：这是一项随机、假对照、观察者盲的前瞻性研究。在 12 名 BEB 患者中，我们评估了 15 分钟低频 (0.2 Hz) 重复经颅磁刺激 (rTMS) 对 ACC 的影响，刺激强度为 100% 主动运动阈值，使用 3 个刺激线圈：传统圆形线圈 (C 线圈)、假线圈 (S 线圈) 和 Hesed 线圈 (H 线圈，可刺激更深层的大脑区域。主要结果是对 BEB 的临床影响（眨眼率、刺激前、刺激后立即和刺激后 1 小时由盲法医生评定的痉挛次数）；次要结果是眨眼反射恢复曲线。结论：rTMS 可以用作 BEB 的治疗工具，以证明重复刺激应用是否会产生持久的临床效果。证据分类：本研究提供了 II 类证据，表明 H 线圈和 C 线圈 rTMS 是安全的，并且可以在刺激后立即和 1 小时改善 BEB 的临床症状。
Background: Benign essential blepharospasm (BEB) is a common form of focal dystonia. Besides pathology in the basal ganglia, accumulating evidence suggests pathologic changes in the anterior cingulate cortex (ACC). Methods: This is a randomized, sham-controlled, observer-blinded prospective study. In 12 patients with BEB, we evaluated the effects of a 15-minute session of low-frequency (0.2 Hz) repetitive transcranial magnetic stimulation (rTMS) over the ACC with stimulation intensities at 100% active motor threshold with 3 stimulation coils: a conventional circular coil (C-coil), a sham coil (S-coil), and a Hesed coil (H-coil, which allows stimulation of deeper brain regions. Primary outcome was the clinical effects on BEB (blink rate, number of spasms rated by a blinded physician and patient rating before, immediately after, and 1 hour after stimulation); secondary outcome was the blink reflex recovery curve. Results: Subjective stimulation comfort was similar for each coil with no stimulation-associated adverse events. Stimulation with the H- and C-coils resulted in a significant improvement in all 3 outcome measures and was still detectable in physician rating and patient rating 1 hour after stimulation. S-coil stimulation had no effects. The active motor threshold was significantly lower for the H-coil compared to the other 2 coils. Conclusions: rTMS could be used as a therapeutic tool in BEB. Further studies will be necessary to show whether repeated stimulation applications result in lasting clinical effects. Classification of evidence: This study provides Class II evidence that for patients with BEB, H- and C-coil rTMS is safe and improves clinical symptoms of BEB immediately and 1 hour after stimulation.
影响因子：
2.5
作者：
Hanakawa, T;Parikh, S;Hallett, M
通讯作者：
Hallett, M
动物模型解释了颅骨肌张力障碍良性原发性眼睑痉挛的起源。
影响因子：
2.5
作者：
Schicatano,EJ;Basso,MA;Evinger,C
通讯作者：
Evinger,C