A research about development of new rehabilitation technique of motor function with brain magnetic stimulation in elder persons

目的：观察连续4天经颅磁刺激（TMS）最大随意肌收缩（MVC）训练对老年人运动神经元功能的影响，记录运动诱发电位（MEPs）和最大挤压肌力。方法：记录经颅磁刺激（TMS）以最大肌肉力按压按钮式应变传感器2秒时，第1条数字骨间肌（FDI）的4个mep，每隔15分钟一次，直到开始1小时（测试条件）。在对照条件下，除了在第1天和第4天的会议开始前和1小时后给记录的MEPs提供真实的经颅磁刺激外，使用假经颅磁刺激。结果：两组训练后，FDI肌和捏肌的MEP振幅或面积均显著增加。与对照组相比，测试组在第2天至第4天开始训练前捏肌力有明显增大的趋势。各组间MEP大小变化无显著性差异。结论：虽然本研究提示每日经颅磁刺激与MVC可以促进老年人的肌肉力量，但我们需要进一步的研究来证实这种效果。

Objective : To evaluate the effects of training by transcranial magnetic stimulation(TMS) with maximum voluntary muscle contraction(MVC) for serial 4 days on motor neuron function in elder persons, motor evoked potentials(MEPs) and the maximum pinching muscle force were recorded sequentially.Methods : Four MEPs in the first digital interossei(FDI) muscle elicited by TMS during pinching a button-like strain-gauge transducer with maximum muscle force for 2 seconds were recorded before and at an each 15 minutes interval until 1 hour after starting the sessions(test condition). In a control condition, sham TMS was employed except that real TMS was delivered to record MEPs before and 1 hour after onsets of the sessions in Day 1 and 4.Results : MEP amplitudes or areas in FDI muscle and pinching muscle force were significantly increased after the sessions in the both conditions. Pinching muscle force tended to be significantly larger before starting the sessions from Day 2 to Day 4 in the test condition compared with the control condition. Changes of MEP sizes did not significantly differ between the groups.Conclusion : Although the present study suggests that daily TMS with MVC facilitates muscle power in elder persons, we need further studies to confirm this effect of TMS with MVC.