Stroke:卒中后失语早期使用无创性脑刺激有助语言功能恢复

2013-07-15 geniusgodyu dxy

使用重复性经颅磁刺激(rTMS)调节语言网络的活动可能有助卒中后失语的恢复。病例系列报道及可行性研究提示可能的治疗效果,但是,还没有对临床效果与激活模式进行关联的随机空白对照原理验证研究。为此,加拿大McGill大学神经科的AlexanderThiel博士等人进行了一项研究,研究结果在线发表在2013年6月27日的Stroke杂志上。研究结果显示:后下额回进行10节的抑制性rTMS联合语言康复治疗


使用重复性经颅磁刺激(rTMS)调节语言网络的活动可能有助卒中后失语的恢复。病例系列报道及可行性研究提示可能的治疗效果,但是,还没有对临床效果与激活模式进行关联的随机空白对照原理验证研究。为此,加拿大McGill大学神经科的AlexanderThiel博士等人进行了一项研究,研究结果在线发表在2013年6月27日的Stroke杂志上。研究结果显示:后下额回进行10节的抑制性rTMS联合语言康复治疗,显著提高亚急性缺血性卒中患者的语言功能恢复,有助左半脑语言网络功能的恢复。

研究人员将24位亚急性卒中后失语的患者随机分入磁刺激组(为期10天,每日对后下额回的右三角区进行20分钟抑制性1Hz rTMS)和空白刺激组,两组在残疾后均进行45分钟的语言康复治疗。在治疗前后发音时使用氧15水PET测定语言网络的活动度。使用Aachen失语测试量表评估语言能力。

该研究发现:主要结果测量值:全面Aachen失语测定量表得分差值在rTMS组显著增高 (t检验, P=0.003)。增加值最大在命名亚组(P=0.002),而增加值在理解、符号和书写方面趋于较高(P<0.1)。相较空白刺激组患者,rTMS组患者在治疗后激活左半脑相对较多 (激活容量指数上存在差异) (t检验, P=0.002)。激活容量指数改变值与全面Aachen失语测试得分改变值之间存在着中度(但是存在显著性)的线性相关。(r2=0.25; P=0.015)

该研究发现:后下额回进行10节的抑制性rTMS联合语言康复治疗,显著提高亚急性缺血性卒中患者的语言功能恢复,有助左半脑语言网络功能的恢复。


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    2013-07-17 yangjxjc
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    2013-07-17 mnda

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