临床神经外科杂志2023，Vol.20Issue(6)：619-624,6.DOI:10.3969/j.issn.1672-7770.2023.06.004
经颅磁刺激干预意识障碍患者颞顶交界区的疗效分析
Transcranial magnetic stimulation of temporal-parietal junction in patients with disorder of consciousness
摘要
Abstract
Objective To investigate the effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)in the temporoparietal junction(TPJ)in patients with disorders of consciousness(DOC)after TBI.Method 42 DOC patients after brain injury admitted to Shanxi Bethune Hospital from December 2020 to August 2022 were collected and divided into an experimental group of 22 cases and a control group of 20 cases.Patients in the experimental group received rTMS therapy and the control group received sham stimulation.The efficacy evaluation indicators included changes in the revised version of the coma recovery scale-revised(CRS-R)score before and after treatment,as well as changes in mismatched negative waves in event related potentials.Results Within the group comparison,the level of consciousness was 54.5％ after 14 days of treatment,with statistical difference(P=0.002).The control group was 20.0％,with no statistical difference(P＞0.05).In comparison between groups,the difference between the two groups(P=0.020),and the CRS-R score in the test group was more significantly higher than that in the control group.During the treatment,there was statistical difference in mismatch negativity(MMN)amplitude in test group(P=0.011)and statistical difference in incubation period(P=0.006),no statistical difference in MMN amplitude in control group(P＞0.05)and no statistical difference in MMN latency(P＞0.05).Between groups,the difference of MMN between the test and control groups was not statistically significant(P＞0.05),and the difference of MMN was statistically significant(P=0.033).CRS-R score and MMN amplitude were significant(P＜0.001),neither CRS-R score and MMN latency(P＞0.05),CRS-R score and MMN amplitude,CRS-R score and MMN latency correlation(P＞0.05).Conclusions Patients with rTMS in TPJ after brain injury have a certain awakening and regulation effect,and some patients can have behavioral changes or latency and amplitude changes in MMN around the 7th day.Regardless of consciousness impaired patients with intervention,there is a significant correlation between CRS-R score and MMN amplitude,but neither CRS-R score and MMN latency.关键词
意识障碍/颅脑外伤/经颅磁刺激Key words
disorder of consciousness/craniocerebral trauma/transcranial magnetic stimulation分类
医药卫生引用本文复制引用
曾淑娟,刘震洋,牛剑平,石豆豆,杨艺,何江弘,仝海波..经颅磁刺激干预意识障碍患者颞顶交界区的疗效分析[J].临床神经外科杂志,2023,20(6):619-624,6.基金项目
山西省科技成果转化引导专项计划项目(202204021301001) （202204021301001）
