経頭蓋磁気刺激を用いた嚥下障害治療の研究

经颅磁刺激治疗吞咽困难的研究

• 批准号: 15650117
• 负责人: 小山 祐司
• 金额: $ 1.79万
• 依托单位: Tokai University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Exploratory Research
• 财政年份: 2003
• 资助国家: 日本
• 起止时间: 2003 至 2005
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-15650117/
• 关键词: 経頭蓋磁気刺激; 嚥下障害; リハビリテーション; 嚥下中枢; 加齢; 舌骨上筋群; 延髄外側症候群; 球麻痺

誘発反応装置にNeuropack MEB-2200,磁気刺激装置にMagstim200,刺激コイルに8の字(70mm coil, 2.2Tesla)を用いた.ディスポーザブルの表面電極(NCS電極)で双極導出,電極間距離20mmとした.両側舌骨上筋群を導出部位とし,単発磁気刺激で対側の舌骨上筋群の運動誘発電位(MEP)の最大振幅が導出できた部位を至適部位とした.出力は運動閾値の1.2倍の強さとし,背もたれ60度の安楽座位で5回,左右の大脳皮質運動野で刺激し,MEPの潜時を測定した.●1.健常人の舌骨上筋群MEP潜時(平均±標準偏差)70〜79歳(平均73.7±3.3歳:男4名,女2名):(右刺激)7.00±0.73ms,(左刺激)7.52±0.94ms60〜69歳(平均65.5±4.3歳:男0名,女6名):(右刺激)7.96±1.31ms,(左刺激)8.02±0.82ms50〜59歳(平均54.7±2.4歳:男4名,女3名):(右刺激)7.03±0.92ms,(左刺激)6.92±0.96ms40〜49歳(平均43.3±2.1歳:男5名,女1名):(右刺激)8.38±1.54ms,(左刺激)8.25±1.13ms30〜39歳(平均33.3±1.9歳:男4名,女3名):(右刺激)7.49±0.80ms,(左刺激)7.76±0.97ms20〜29歳(平均26.7±2.1歳:男3名,女4名):(右刺激)7.11±0.96ms,(左刺激)7.43±1.09msone-way ANOVAにて各年代(20代〜70代)のMEP潜時に有意差を認めず.unpaired t-testにて各年代の左右MEP潜時に有意差を認めず.加齢による変化は舌骨上筋群MEP潜時において認めず.●2.健常人の舌骨上筋群MEP潜時の再現性1回目と2回目(1ヶ月以降,6ヶ月以内)のMEP潜時は,Pearson's correlation coefficientsにて極めて高い相関を認め(r=0.923,n=16,p<.0001), paired t-testにて有意差を認めず.本測定法の再現性は良好であった.(平均41.0±13.8歳:男7名,女1名.左右で大脳皮質運動野を刺激した)●3.球麻痺患者(脳幹病変)の舌骨上筋群MEP潜時(平均±標準偏差)嚥下反射が誘発されない完全な球麻痺を呈する慢性期患者1例(83歳女性).上記方法と同様に左右の大脳皮質運動野で刺激したところ,対側の舌骨上筋群MEP潜時が得られた.(右刺激)7.75±0.10ms,(左刺激)7.09±0.08ms

Neuropack MEB-2200, Magnetic Stimulator Magstim 200, Stimulator 8mm coil, 2.2Tesla The surface electrode (NCS electrode) is bipolar, and the distance between electrodes is 20 mm. The maximum amplitude of motor induced potential (MEP) of the suprahyoid muscle group on the opposite side was determined by magnetic field stimulation. The strength of motor threshold was 1.2 times higher than that of motor threshold. The motor activity of motor cortex was 60 degrees higher than that of motor threshold. The latency of MEP was measured.● 1. MEP latency of healthy people (Mean ± SD) 70 to 79 years (Average 73.7 ± 3.3 years: 4 males, 2 females):(right stimulus) 7.00 ± 0.73ms,(left stimulus) 7.52 ± 0.94ms 60~69 years (Average 65.5 ± 4.3 years: 0 male, 6 female):(right stimulus) 7.96 ± 1.31ms,(left stimulus) 8.02 ± 0.82ms 50~59 years (Average 54.7 ± 2.4 years: 4 males, 3 females):(right stimulus) 7.03 ± 0.92ms,(left stimulus) 6.92 ± 0.96ms 40~49 years (Average 43.3 ± 2.1 years: 5 males, 1 female):(right stimulus) 8.38 ± 1.54ms,(left stimulus) 8.25 ± 1.13ms 30~39 years (Average 33.3 ± 1.9 years: 4 males, 3 females):(right stimulus) 7.49 ± 0.80ms,(left stimulus) 7.76 ± 0.97ms20~29 years (average 26.7 ± 2.1 years old: 3 males, 4 females):(right stimulus) 7.11 ± 0.96ms,(Left stimulus) 7.43 ± 1.09 msone-way ANOVA for MEP latency of all ages (20~70 generations). In addition, the MEP potential of the hyoid tendon group is increased.● 2. The reproducibility of MEP latency in suprahyoid muscle group of healthy people was compared with Pearson's correlation coefficients (r = 0.923, n = 16, p <.0001), paired t-test and intentional difference. The reproducibility of this assay is excellent. (Average 41.0 ± 13.8 years old: 7 males, 1 female). 3. MEP latency (mean ± SD) of suprahyoid muscle group in patients with bulbar paralysis (dry disease). The method described above is similar to that of the motor field stimulation of the left and right major cortex, and the MEP latency of the opposite superior hyoid muscle group is obtained. (right stimulus) 7.75 ± 0.10ms,(left stimulus) 7.09 ± 0.08ms