低頻度反復経頭蓋磁気刺激による左半側視空間無視の治療

低频重复经颅磁刺激治疗左侧视觉空间忽视

• 批准号: 17700436
• 负责人: 新藤 恵一郎
• 金额: $ 2.3万
• 依托单位: Tohoku University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Young Scientists (B)
• 财政年份: 2005
• 资助国家: 日本
• 起止时间: 2005 至 2006
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-17700436/
• 关键词: リハビリテーション; 脳神経疾患; 臨床; 神経科学

左半側空間無視(USN)に対する反復経頭蓋磁気刺激(rTMS)の効果を検討した。【対象】脳卒中患者8例(男性4例、脳梗塞6例、平均発症6.5ヶ月、行動性無視検査(BIT)通常平均67、MMSE/HDS-R平均18.7。【rTMS】Magstim Rapid System 1000/50(Magstim社製)を用い、左頭頂葉後部(P5)直上を、運動閾値の95%強度、1Hz、1回900発で、週3回2週間(合計6回)施行。施行中はMEB-9104(日本光電社製)で、左短母指外転筋運動誘発電位、脳波(C4〜右耳朶)を記録。対象を実刺激群とSham刺激に無作為に割り付け、Sham刺激群では、2週間のSham刺激後に実刺激を希望した場合には、実刺激を実施した。【評価】BIT、MMSE/HDS-R、片麻痺、日常生活自立度を、介入2週間前、直前、直後、2、4週間後に、また脳血流シンチ(^<123I>-IMP定量)を介入2週間前、2週間後に評価した。平行して理学・作業療法を週5日実施。【結果】8例中4例が脱落(水頭症・頭蓋形成部感染・本人の中止希望・痙攣発作)。【症例1】59歳男性、脳梗塞発症後半年、BIT通常68。HDS-R21。BITは刺激2週間後までBIT通常100と改善したが、4週間後に70と低下。【症例2】61歳女性、脳梗塞発症後半年、BIT通常35、MMSE23、左同名半盲あり。BITは刺激4週間後まで改善傾向(83点)であった。【症例3】72歳男性、脳塞栓発症後7ヶ月。BIT通常23、MMSE14。刺激後、MMSE19と改善したが、BITには大きな変化を認めず。【症例4】76歳男性、脳梗塞発症後8ヶ月、BIT通常22、MMSE14。刺激後MMSE16となったがBITに変化を認めず。いずれの症例においても、片麻痺、日常生活自立度、脳血流シンチには変化がみられなかった。【考察】非損傷半球頭頂葉へのrTMSは、USNや認知障害を改善する可能性が示唆されたが、症例により効果に差がみられた。

The effects of repeated cranial magnetic stimulation (rTMS) on the left hemisphere were discussed. 8 stroke patients (4 males, 6 infarction patients, average symptom 6.5 months, BIT average 67, MMSE/HDS-R average 18.7). [rTMS] Magstim Rapid System 1000/50(Magstim) is applied in the middle, right upper part of left parietal lobe (P5), 95% intensity of exercise threshold value, 1 Hz, 1 cycle of 900 seconds, 3 cycles per week and 2 weeks (total 6 cycles). MEB-9104(manufactured by Nippon Optoelectronics Corporation) was used to record the induced potential and sound wave (C4 ~ right ear) of the outer tendon of the left short finger. Sham stimulation is not effective for both groups of stimuli. Sham stimulation is effective for both groups of stimuli. BIT, MMSE/HDS-R, Paralysis, Self-reliance of Daily Living, 2 weeks before, immediately after, <123I>2 weeks after, and 2 weeks after the intervention. Parallel science and occupational therapy is administered on the 5th of every week. [Results] 4 out of 8 cases were lost (head syndrome, infection of head formation, termination of self hope, convulsion). [Case 1] 59 years old male, half a year after infarction, BIT usually 68. HDS-R21。BIT usually improves by 100 after 2 weeks of stimulation, and decreases by 70 after 4 weeks. [Case 2] 61-year-old female, half a year after infarction, BIT usually 35, MMSE23, left homonymic semi-blind BIT stimulation improved after 4 weeks (83 points) [Case 3] 72-year-old male, 7 months after the onset of embolism. BIT is usually 23 and MMSE14. After stimulation, MMSE19 [Case 4] 76-year-old male, 8 months after infarction, BIT usually 22, MMSE14. After stimulation MMSE16 The symptoms of epilepsy, paralysis, independence of daily life, and blood flow are different. [Investigation] The possibility of improving cognitive impairment by rTMS in non-injured hemisphere parietal lobe was investigated.

项目成果

Long-term effect of low-frequency repetitive transcranial magnetic stimulation over the unaffected posterior parietal cortex in patients with unilateral spatial neglect

• DOI: 10.1080/16501970500441807
• 发表时间: 2006-01-01
• 期刊: JOURNAL OF REHABILITATION MEDICINE
• 影响因子: 3.5
• 作者: Shindo, K;Sugiyama, K;Izumi, SI
• 通讯作者: Izumi, SI