低频重复经颅磁刺激联合镜像神经元训练系统对卒中后慢性完全性失语的效果研究

doi:10.3969/j.issn.1673-5765.2021.01.008

摘要/Abstract

摘要：

目的观察低频重复经颅磁刺激（repetitive transcranial magnetic stimulation，rTMS）联合镜像神经元训练系统（mirror neuron training system，MNTS）对卒中后慢性完全性失语患者的临床效果。方法前瞻性连续纳入2018年1月-2020年1月于南京医科大学附属脑科医院康复医学科住院的30 例卒中后慢性完全性失语患者，按随机数字表法分为对照组、MNTS组和联合组，每组10例。对照组仅给予常规言语康复训练，MNTS组在对照组的基础上给予镜像神经元训练，联合组在MNTS组的基础上给予右侧Broca同源区1 Hz的rTMS治疗。分别于治疗前和治疗3周后对三组患者进行西方失语成套测验（western aphasia battery，WAB）以及波士顿诊断性失语检查（Boston diagnostic aphasia examination，BDAE）评定。结果治疗前三组患者一般资料及WAB各子项评分、BDAE分级组间差异无统计学意义。治疗后联合组WAB各子项及BDAE分级均较治疗前提高，差异均有统计学意义。治疗后联合组WAB子项自发言语（P =0.007）、复述（P =0.027）、信息量（P =0.009）、失语商（P =0.041），以及BDAE分级（P =0.012）高于对照组，自发言语（P =0.033）高于MNTS组。结论低频rTMS联合MNTS对改善卒中后慢性完全性失语患者的语言功能有一定的作用。

文章导读： 本研究表明，镜像神经元训练系统联合rTMS抑制右侧Broca同源区可以促进卒中后慢性完全性失语患者语言功能的恢复，可以作为言语功能康复的有效辅助手段。

关键词: 重复经颅磁刺激; 完全性失语; 卒中; 镜像神经元训练系统; 康复疗效

Abstract:

Objective To explore the clinical effect of inhibitory repetitive transcranial magnetic stimulation (rTMS) combined with mirror neuron training system (MNTS) on chronic global aphasia poststroke. Methods 30 patients with chronic global aphasia poststroke at Department of Rehabilitation Medicine of the Affiliated Nanjing Brain Hospital of Nanjing Medical University between January 2018 and January 2020 were prospectively enrolled in this study, and all the patients were randomly divided into control group, MNTS group and combined treatment group, with 10 cases in each group. The control group was only given conventional speech rehabilitation training, the MNTS group was given mirror neuron system training on the basis of the control group, and the combined treatment group was given rTMS stimulation of 1 Hz in the right Broca homologous region on the basis of the MNTS group, with once a day for a week. The 3 groups were evaluated using the western aphasia battery (WAB) and Boston diagnostic aphasia examination (BDAE) before and 3 weeks after treatment. Results There was no statistical difference in the baseline general information and WAB and BDAE scores among the 3 groups before treatment. After treatment, the spontaneous speech (P =0.007), repetition (P =0.027), information content (P =0.009), aphasia quotient of WAB (P =0.041) and BDAE (P =0.012) in combined treatment group were all higher than that in control group, and the spontaneous speech in combined treatment group was better than that in MNTS group (P =0.033). Conclusions Inhibitory rTMS combined with MNTS can significantly improve the language function of patients with chronic global aphasia poststroke.

Key words: Repetitive transcranial magnetic stimulation; Global aphasia; Stroke; Mirror neuron training system; Rehabilitation effect

朱慧敏，张新颜，程欣欣，饶江，张羽，刘莉. 低频重复经颅磁刺激联合镜像神经元训练系统对卒中后慢性完全性失语的效果研究[J]. 中国卒中杂志, 2021, 16(01): 45-50.

ZHU Hui-Min, ZHANG Xin-Yan, CHENG Xin-Xin, RAO Jiang,ZHANG Yu, LIU Li. The Effect of Inhibitory Repetitive Transcranial Magnetic Stimulation Combined with Mirror Neuron Training System on Chronic Global Aphasia Poststroke[J]. Chinese Journal of Stroke, 2021, 16(01): 45-50.

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