1. 中山大学附属第七医院康复医学科,深圳
2. 中山大学附属第七医院神经医学中心,深圳
3. 西安欧亚学院人文教育学院,西安
4. 西安交通大学社会心理学研究所,西安
5. 广东省康复医学与转化工程技术研究中心,广州
纸质出版:2024
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辛榕, 余贤娴, 程斯曼, 等. 基于脑电微状态和表面肌电观察重复经颅磁刺激对脑卒中后右侧偏瘫患者上肢运动功能的影响[J]. 中华物理医学与康复杂志, 2024,46(9):791-798.
辛榕, 余贤娴, 程斯曼, et al. 基于脑电微状态和表面肌电观察重复经颅磁刺激对脑卒中后右侧偏瘫患者上肢运动功能的影响[J]. 2024, 46(9): 791-798.
目的基于脑电微状态和表面肌电观察高频重复经颅磁刺激(rTMS)对脑卒中后右侧偏瘫患者上肢运动功能的影响。方法将脑卒中后右侧偏瘫患者40例按随机数字表分为高频rTMS组和假刺激组
每组患者20例。高频rTMS组和假刺激组均接受常规康复治疗
在此基础上
高频rTMS组增加rTMS治疗
假刺激组则接受假rTMS治疗。rTMS治疗每日刺激1次
每周治疗5 d
连续治疗2周。于治疗前和治疗2周后(治疗后)对2组患者分别进行上肢运动功能评估[Fugl-Meyer上肢运动功能评定量表(FMA-UE)]、表面肌电(sEMG)检测和脑电微状态检测
同时记录2组患者治疗过程中的不良反应。结果治疗后
2组患者的FMA-UE量表评分较组内治疗前均显著提升
差异均有统计学意义(P<0.05)
且高频rTMS组患者治疗后的FMA-UE量表评分亦显著高于假刺激组治疗后
差异有统计学意义(P<0.05)。治疗后
高频rTMS组桡侧腕长伸肌sEMG的峰-峰值为(7.55±3.73)mV
较组内治疗前和假刺激组治疗后均显著提高
差异均有统计学意义(P<0.05)。治疗后
高频rTMS组治疗后微状态B的时间覆盖率、微状态C的平均持续时间和时间覆盖率
以及微状态D治疗后的时间覆盖率和出现频率均显著优于组内治疗前和假刺激组治疗后
差异均有统计学意义(P<0.05)。脑电微状态A的平均持续时间与FMA-UE量表评分呈负相关(r=-0.568
P=0.027)。脑电微状态A的时间覆盖率与尺侧腕屈肌sEMG的峰-峰值呈正相关
脑电微状态B的平均持续时间与肱三头肌sEMG的峰-峰值和三角肌sEMG峰-峰值呈正相关
脑电微状态C的平均持续时间与三角肌sEMG的峰-峰值呈正相关。结论高频rTMS可有效地改善脑卒中后右侧偏瘫患者上肢运动功能
且经高频rTMS治疗后
脑卒中患者脑电微状态B相关的功能网络活动显著增加
而微状态C和微状态D相关的功能网络活动则显著减少。
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Electronic address: jean-pascal.lefaucheur@hmn.aphp.fr.,Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Psychiatry and Medical Psychology, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium,Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.,Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.,PsyR2 Team, U1028, INSERM and UMR5292, CNRS, Center for Neuroscience Research of Lyon (CRNL), Centre Hospitalier Le Vinatier, Lyon-1 University, Bron, France.,Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.,Department of Human Neuroscience, Institute for Medical Research, University of Belgrade, Belgrade, Serbia.,Department of Neurology, Cologne University Hospital, Cologne, Germany,Institute of Neurosciences and Medicine (INM3), Jülich Research Centre, Jülich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.,Defitech Chair in Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland,Defitech Chair in Clinical Neuroengineering, Swiss Federal Institute of Technology (EPFL) Valais and Clinique Romande de Réadaptation, Sion, Switzerland,Clinical Neuroscience, University of Geneva Medical School, Geneva, Switzerland.,Department of Clinical Neurophysiology, Turku University Hospital and University of Turku, Turku, Finland.,Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Department of Neurorehabilitation and Experimental Neurophysiology Unit, Institute of Experimental Neurology (INSPE), IRCCS San Raffaele, University Vita-Salute San Raffaele, Milan, Italy.,Department of Otorhinolaryngology - 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