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Recovery of hemiplegia after stroke using transcranial magnetic stimulation

经颅磁刺激恢复中风后偏瘫

基本信息

批准号：
15300191
负责人：
IZUMI Shinichi
金额：
$ 10.37万
依托单位：
Tohoku University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
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/grant/KAKENHI-PROJECT-15300191/
关键词：
stroke hemiplegia transcranial magnetic stimulation therapy 脳神経疾患脳卒中 MRI

项目摘要

Purpose : We evaluated therapeutic effectiveness of transcranial magnetic stimulation (TMS) during maximal effort at a target movement in patients with chronic hemiplegia involving the hand.Subjects : 9 stroke patients with hemiplegia for at least 6 monthsDesign : Double-blinded trialMethods : For the intervention group (n=5), TMS (100 stimuli ; intensity, 80% of stimulator output ; interstimulus interval, 10 sec) was administered at the optimal site for the extensor digitorum muscle of the affected side weekly during maximal effort at finger extension for 4 weeks. For control group (n=4), sham stimulation was delivered otherwise in the same way as the intervention group. The outcome measures were Brunnstrom's recovery stage, Stroke Impairment Assessment Set (SIAS), Modified Ashworth Scale (MAS) for the wrist, Manual Function Test (MFT), tested just before the 1st and immediately after 4th session.Results : All the participants completed the trial, without any adverse. 4 participants of the intervention group showed improvement for either MAS or MFT, while participants of the control group showed neither of these scales (chi square test, P<0.05). One participant of each group showed improvement of the hand motor function for either Brunnstrom's recovery stage or SIAS. Either MAS or MFT improved in all the participants who showed enhancement of amplitudes for motor evoked potentials to TMS more than 30%.Conclusions : Repetitive TMS over the affected hemisphere of the hemiplegic stroke patients synchronized with maximal effort at a target movement improves the voluntary movement or reduces spasticity.

目的：评价经颅磁刺激(TMS)对慢性手部偏瘫患者的治疗效果。研究对象：9例脑卒中偏瘫患者，持续6个月以上。设计：双盲试验：干预组(n=5)在伸指最大力时每周对患侧伸指伸肌最佳部位进行经颅磁刺激(TMS)，刺激强度为刺激强度的80%，刺激间隔为10s，共4周。对照组(n=4)给予假刺激，与干预组相同。采用Brunnstrom‘s恢复期、卒中损害评定量表(SIAS)、改良Ashworth腕关节功能评定量表(MAS)、手动功能测验(MFT)分别于第1次会议前和第4次会议结束后进行测试。结果：所有受试者均完成试验，无不良反应。4干预组MAS或MFT均有改善，而对照组均无改善(卡方检验，P&lt；0.05)。在Brunnstrom‘s恢复期或SIAS期间，每组都有一名参与者的手运动功能有所改善。所有运动诱发电位波幅提高30%以上的患者MAS或MFT均有改善。结论：脑卒中偏瘫患者患侧重复TMS，同步于目标运动的最大努力，可改善自主性运动或减少痉挛。