| 毛佳宁,
，张皓,
，崔利华.小脑经颅磁刺激对脑卒中偏瘫患者平衡及运动功能的影响[J].神经损伤功能重建,2024,(10):574-578 |
| 小脑经颅磁刺激对脑卒中偏瘫患者平衡及运动功能的影响 |
| The Effect of Cerebellar Transcranial Magnetic Stimulation on Balance and Motor Functionin Patients with Hemiplegia Following Stroke |
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| DOI： |
| 中文关键词: 脑卒中 小脑 经颅磁刺激 平衡功能 运动功能 间歇性θ爆发刺激 弥散张量成像 |
| 英文关键词: stroke cerebellum transcranial magnetic stimulation balance function motor function intermittent Theta burst
Stimulation diffusion tensor imaging |
| 基金项目: |
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| 摘要点击次数: 17 |
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| 中文摘要: |
| 目的：探讨小脑间歇性θ爆发刺激（iTBS）结合常规物理治疗对脑卒中偏瘫患者的运动及平衡功能的
影响。方法：选取2021年5月至2023年12月北京丰台右安门医院脑卒中患者40例，随机分成对照组和试
验组，各 20 例。2 组均进行常规药物和康复治疗，试验组在康复治疗前给予小脑 iTBS，对照组给予伪刺
激。治疗前及治疗 2 周后评估运动及平衡功能，包括 Berg 平衡量表（BBS）、Fugl-Meyer 运动功能评价
（FMA）、改良Barthel指数（mBI）；并行弥散张量成像（DTI）检查，测量3对小脑脚的各向异性分数（FA）值与
表观弥散系数（ADC）值。结果：治疗前，2组的BBS、FMA及mBI评分差异无统计学意义（P＞0.05）。治疗
后，2组的BBS、FMA及mBI评分均显著提高（P＜0.01），且试验组高于对照组（P＜0.05）。治疗前，2组小脑
脚的 FA 值差异无统计学意义（P＞0.05）。治疗后，2 组间病灶侧的小脑脚 FA 值差异无统计学意义（P＞
0.05），非病灶侧小脑上脚试验组FA值高于对照组（P＜0.05）。试验组内，非病灶侧小脑上脚的FA值治疗后
比治疗前增大（P＜0.05）。对照组内，病灶侧与非病灶侧3对小脑脚的FA值治疗前后比较差异均无统计学
意义（P＞0.05）。治疗后，小脑脚的ADC在组间与组内、病灶侧与非病灶侧比较，差异均无统计学意义（P＞
0.05）。结论：小脑iTBS治疗可促进脑卒中偏瘫患者运动及平衡功能的恢复，其机制可能与iTBS通过小脑
进行皮质重组、提高神经传导能力及可塑性有关。 |
| 英文摘要: |
| To investigate the effects of intermittent theta burst stimulation (iTBS) of the cerebellum
combined with conventional physical therapy on motor and balance functions in patients with hemiplegia
following stroke. Methods: Forty stroke patients admitted to Beijing Fengtai You'anmen Hospital from May
2021 to December 2023 were selected and randomly divided into a control group and an experimental group,
with 20 cases in each. Both groups received conventional pharmacological and rehabilitation treatments, while
the experimental group received cerebellar iTBS prior to rehabilitation therapy, and the control group received
sham stimulation. Motor and balance functions were assessed using the Berg Balance Scale (BBS), Fugl-Meyer
Assessment (FMA), and the Modified Barthel Index (mBI) before treatment and two weeks after treatment.
Diffusion Tensor Imaging (DTI) was performed to measure Fractional Anisotropy (FA) and Apparent Diffusion
Coefficient (ADC) values of three pairs of cerebellar peduncles. Results: There was no statistically significant
difference in BBS, FMA, and mBI scores between the two groups before treatment (P>0.05). After treatment,
BBS, FMA, and mBI scores increased significantly in both groups (P<0.01), and the experimental group scored
higher than the control group (P<0.05). Before treatment, there was no statistically significant difference in FA
values of the cerebellar peduncles between the two groups (P>0.05). After treatment, there was no statistically
significant difference in FA values of the affected-side cerebellar peduncles between the two groups (P>0.05), but the non-affected-side
superior cerebellar peduncle FA value was higher in the experimental group than in the control group (P<0.05). Within the experimental
group, the FA value of the non-affected-side superior cerebellar peduncle increased after treatment compared to before treatment (P<0.05).
Within the control group, there was no statistically significant difference in FA values of the affected-side and non-affected-side cerebellar
peduncles before and after treatment (P>0.05). After treatment, there was no statistically significant difference in ADC values of the
cerebellar peduncles between the groups or between the affected-side and non-affected-side within groups (P>0.05). Conclusion:
Cerebellar iTBS treatment can promote the recovery of motor and balance functions in patients with hemiplegia following stroke. The
mechanism may be related to iTBS-induced cortical reorganization through the cerebellum, improving neural conduction ability and
plasticity. |
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