CAJ | 학술논문

目的：观察1 Hz重复经颅磁刺激(rTMS)对缺血性脑卒中后偏瘫上肢运动功能康复的效果。方法40例缺血性脑卒中后上肢偏瘫患者被随机分配到治疗组(n=20)和对照组(n=20)。两组均给予常规康复治疗，治疗组采用rTMS刺激健侧皮层M1区，对照组给予假刺激。治疗后采用运动诱发电位(MEPs)、Fugl-Meyer上肢运动功能评分(FMA)和握力进行评定。结果治疗后，治疗组患侧MEPs振幅显著升高(P<0.001)。治疗组握力和FMA评分显著优于对照组(P<0.001)，并至少可持续到治疗结束后1个月。所有患者均能耐受10次治疗，无严重不良反应发生。结论 rTMS刺激健侧皮层M1区可改善缺血性脑卒中后偏瘫上肢的运动功能。
목적：관찰1 Hz중복경로자자격(rTMS)대결혈성뇌졸중후편탄상지운동공능강복적효과。방법40례결혈성뇌졸중후상지편탄환자피수궤분배도치료조(n=20)화대조조(n=20)。량조균급여상규강복치료，치료조채용rTMS자격건측피층M1구，대조조급여가자격。치료후채용운동유발전위(MEPs)、Fugl-Meyer상지운동공능평분(FMA)화악력진행평정。결과치료후，치료조환측MEPs진폭현저승고(P<0.001)。치료조악력화FMA평분현저우우대조조(P<0.001)，병지소가지속도치료결속후1개월。소유환자균능내수10차치료，무엄중불량반응발생。결론 rTMS자격건측피층M1구가개선결혈성뇌졸중후편탄상지적운동공능。
Objective To observe the effect of 1 Hz repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function af-ter stroke. Methods 40 patients with ischemic internal carotid artery (ICA) stroke were randomly divided into treatment group (n=20) and control group (n=20). Both groups received conventional rehabilitation and medication. The treatment group received rTMS while the con-trol group received pseudo stimulation, 1 Hz at 100%resting motor threshold (RMT) over contralesional motor cortex (unaffected side). The treatment group was tested with motor evoked potentials (MEPs), and both groups were assessed with Fugl-Meyer Assessment (FMA) and grip strength after treatment. Results The amplitude of MEPs of the unaffected cortex increased in the treatment group after treatment (P<0.001). The treatment group improved in grip strength and the scores of FMA in the affected side compared with the control group after treat-ment (P<0.001). No serious side-effect was found. Conclusion rTMS was safe and feasible for patients with ischemic ICA stroke to im-prove the upper limb motor function.