Exploring Theta Burst Stimulation as an intervention to improve motor recovery in chronic stroke
Exploring Theta Burst Stimulation as an intervention to improve motor recovery in chronic stroke
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DOI：
10.1016/j.clinph.2006.10.014
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发表时间：
2007-02-01
影响因子：
4.7
通讯作者：
Rothwell, J. C.
中科院分区：
文献类型：
--
作者：
Talelli, P.;Greenwood, R. J.;Rothwell, J. C.
目的：探讨单次重复经颅磁刺激（Theta Burst Stimulation）对慢性卒中患者手部功能行为和生理测量的影响。方法：六名手部不完全恢复的慢性卒中患者在三种条件下进行测试：中风半球兴奋性 TBS（iTBS（SH））、完整半球抑制性 TBS（cTBS（IH））和假刺激。行为结果包括简单反应时间范例和选择反应时间范例。使用两侧的单脉冲 TMS 评估生理效应。 TBS 后 40 分钟内观察变化。结果：iTBSSH 后，瘫痪手的简单反应时间立即减少，并且与假刺激相比，在整个测试期间仍然显着缩短。 iTBS(SH) 后，中风侧静息和背景收缩期间 MEP 的幅度以及输入-输出曲线下的面积也有所增加。 cTBS(IH) 抑制了健康手部诱发的 MEP，但没有改变瘫痪手部的运动行为或电生理学。没有遇到任何副作用。结论：TBS 对于慢性中风患者似乎是安全的。中风半球的 iTBS 暂时改善了偏瘫手的运动行为和皮质脊髓输出。意义：兴奋性 TBS 可能代表一种有用的 rTMS 方案，可在未来的长期治疗试验中应用于中风半球。 (c) 2006 年国际临床神经生理学联合会。由爱思唯尔爱尔兰有限公司出版。保留所有权利。
Objective: To explore the effects of a single session of repetitive Transcranial Magnetic Stimulation, given as Theta Burst Stimulation, on behavioural and physiological measures of hand function in chronic stroke patients.Methods: Six chronic stroke patients with incomplete recovery of the hand were tested under three conditions: excitatory TBS over the stroke hemisphere (iTBS(SH)), inhibitory TBS (cTBS(IH)) over the intact hemisphere and sham stimulation. Behavioural outcomes included simple and choice reaction time paradigms. Physiological effects were assessed using single pulse TMS on both sides. Changes were sought for up to 40 min after TBS.Results: Immediately after iTBSSH simple reaction times in the paretic hands were decreased and, compared to sham stimulation, remained significantly shorter throughout the testing period. The amplitude of the MEPs at rest and during background contraction and the area under the Input-Output curves were also increased on the stroke side after iTBS(SH). cTBS(IH) suppressed the MEPs evoked in the healthy hands but did not change motor behaviour or the electrophysiology of the paretic hands. No side effects were encountered.Conclusions: TBS seems safe in chronic stroke patients. iTBS over the stroke hemisphere transiently improved motor behaviour and corticospinal output in the paretic hands.Significance: Excitatory TBS may represent a useful rTMS protocol to apply to the stroke hemisphere in future longer term therapy trials. (c) 2006 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.