Low-frequency rTMS combined with intensive occupational therapy for upper limb hemiparesis after brain tumour resection
Low-frequency rTMS combined with intensive occupational therapy for upper limb hemiparesis after brain tumour resection
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DOI：
10.3109/02699052.2010.523040
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发表时间：
2010-01-01
期刊：
影响因子：
1.9
通讯作者：
Umemori, Takuma
中科院分区：
文献类型：
--
作者：
Kakuda, Wataru;Abo, Masahiro;Umemori, Takuma
目的：评估低频重复经颅磁刺激（rTMS）联合作业疗法（OT）治疗脑肿瘤切除术后偏瘫患者的安全性、可行性和有效性。参与者：一名39岁右利手女性接受了脑肿瘤切除术，5年后出现右上肢轻偏瘫。入院时，尽管进行了传统的作业治疗，但患者的上肢运动功能恢复可能已达到平台状态。干预：在强化作业治疗后，对右侧初级运动皮层进行1 Hz的低频rTMS在15天的住院期间，每天提供一对一训练和自我训练。采用Fugl-Meyer评定法和Wolf运动功能测试法对患者上肢运动功能进行评定。结果：治疗期间患者无明显不良反应，神经症状无明显加重。15天的组合协议改善了右上肢的运动功能，并进一步改善，注意到4周后出院。结论：拟议的协议低频rTMS与强化职业治疗是一个潜在的有用的上肢偏瘫脑肿瘤切除术后的康复计划。
Objective: To assess the safety, feasibility and efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with occupational therapy (OT) in a hemiparetic patient who had undergone brain tumour resection.Participant: A 39-year-old right-handed woman underwent brain tumour resection and presented 5 years later with right upper limb hemiparesis. At admission, she was considered to have reached a probable plateau state of motor functional recovery of the affected upper limb in spite of conventional occupational therapy.Intervention: Low-frequency rTMS with 1 Hz applied to the right primary motor cortex followed by intensive occupational therapy (one-on-one training and self-training) was provided daily during the 15-day hospitalization.Main outcome measures: Fugl-Meyer Assessment and Wolf Motor Function Test were conducted serially to evaluate motor function on the affected upper limb.Results: Neither adverse effect nor deterioration of neurological symptoms was recognized during the treatment period. The 15-day combination protocol improved motor function of the right upper limb and further improvement was noted 4 weeks after discharge.Conclusion: The proposed protocol of low-frequency rTMS with intensive occupational therapy is a potentially useful rehabilitative programme for upper limb hemiparesis after brain tumour resection.