神经损伤与功能重建2025，Vol.20Issue(5)：266-270,292,6.DOI:10.16780/j.cnki.sjssgncj.20241327
外周-中枢联合磁刺激对脑卒中后偏瘫肩痛及体感诱发电位的影响
The Impact of Peripheral-Central Combined Magnetic Stimulation on Post-stroke Hemiplegic Shoulder Pain and Somatosensory Evoked Potentials
摘要
Abstract
Objective:To observe the clinical efficacy of repetitive peripheral magnetic stimulation(rPMS)combined with repetitive transcranial magnetic stimulation(rTMS)on post-stroke hemiplegic shoulder pain(HSP)and its impact on the somatosensory evoked potentials(SEPs)of the median nerve in the affected upper limb.Methods:Forty patients with HSP were randomly divided into an observation group(20 cases)and a control group(20 cases)using a random number table method.Both groups received conventional rehabilitation training.In addition,the control group was treated with high-frequency rTMS over the primary motor cortex of the affected side,while the observation group was treated with high-frequency rPMS targeting the painful trigger points of the rotator cuff muscles of the affected shoulder,combined with high-frequency rTMS over the primary motor cortex of the affected side.Treatments were administered once daily,five days a week,for four weeks.Before and after the intervention,subjects were assessed using the Short-Form McGill Pain Questionnaire(SF-MPQ),passive joint range of motion(PROM)of the pain-free hemiplegic shoulder,Neer shoulder function score,Modified Barthel Index(MBI),and the latency and amplitude of the N20 component of the median nerve SEP in the affected upper limb.Results:Before the intervention,there were no significant differences in baseline characteristics,SF-MPQ scores,PROM,Neer shoulder function scores,MBI,or the latency and amplitude of the N20 component of the median nerve SEP between the two groups(P＞0.05).After the intervention,both groups showed a significant decrease in SF-MPQ scores compared to baseline(P＜0.01),with a more pronounced decrease observed in the observation group than in the control group(P＜0.05).Both groups also demonstrated significant improvements in PROM,Neer shoulder function scores,MBI,and N20 amplitude compared to baseline(P＜0.05),with more significant improvements observed in the observation group than in the control group(P＜0.05).After the intervention,the N20 latency in the observation group was significantly shorter than before the intervention(P＜0.05),and the difference in N20 latency before and after the intervention was more pronounced in the observation group than in the control group(P＜0.05).However,no significant difference in N20 latency was observed in the control group after the intervention(P＞0.05).Conclusion:Peripheral-central combined magnetic stimulation is significantly effective in improving shoulder pain,shoulder joint function,and activities of daily living in patients with HSP.It also has a beneficial effect on the latency and amplitude of the N20 component of the median nerve SEP,with superior outcomes compared to rTMS treatment alone.关键词
脑卒中/重复经颅磁刺激/重复外周磁刺激/偏瘫肩痛/体感诱发电位Key words
stroke/repetitive transcranial magnetic stimulation/repetitive peripheral magnetic stimulation/hemiplegic shoulder pain/so-matosensory evoked potential分类
临床医学引用本文复制引用
饶尧,张晶晶,张弢,李艳,肖仔仙,杨杨,丁浩..外周-中枢联合磁刺激对脑卒中后偏瘫肩痛及体感诱发电位的影响[J].神经损伤与功能重建,2025,20(5):266-270,292,6.基金项目
上海市长宁区卫健委课题资助项目(基于EEG分析探讨rTMS对轻度认知障碍患者大脑皮层功能代偿及脑网络重组机制的研究,No.20214Y005) （基于EEG分析探讨rTMS对轻度认知障碍患者大脑皮层功能代偿及脑网络重组机制的研究,No.20214Y005）
