中国康复2025，Vol.40Issue(7)：412-417,6.DOI:10.3870/zgkf.2025.07.006
不同频率和刺激部位的重复经颅磁刺激治疗脑卒中后运动性失语的临床研究
Clinical study on the treatment of post-stroke motor aphasia with different frequency repetitive transcranial magnetic stimulation
摘要
Abstract
Objective:To observe the differences in the treatment of post-stroke motor aphasia with repeated tran-scranial magnetic stimulation(rTMS)at different frequencies and stimulation sites.Methods:A total of 99 patients with post-stroke motor aphasia admitted to our hospital were selected as the research subjects and randomly divided into high-frequency group,low-frequency group,and dual stimulation group,with 33 patients in each group.The high-frequency group was stimulated with 10 Hz rTMS to stimulate the left Broca area,and the low-frequency group was stimulated with 1Hz rTMS to stimulate the right Broca mirror area.The dual stimulation group was first given 1 Hz low-frequency stimulation to stimulate the right Broca mirror area,and then received 10 Hz high-frequency stimulation to stimulate the left Broca area every 20 min.All three groups were intervened for 8 weeks.The Boston diagnostic aphasia rating scale(BDAE),Chinese functional communicative competence test(CFCP)score,voice disorder index(VHI),stroke and aphasia quality of life scale(SAQOL-39),as well as the levels of neuron specific enolase(NSE)and brain-derived neurotrophic factor(BDNF)were observed before and after treatment,and the clinical efficacy was evaluated.Results:After 8 weeks of intervention,the BDAE grading of all three groups was better than before intervention(P＜0.05).The dual stimulation group was superior to both the high-frequency and low-frequency groups(P＜0.05).After 8 weeks of intervention,the CFCP in all three groups was higher than be-fore stimulation(P＜0.05),and the VHI was lower than before stimulation(P＜0.05).The dual stimulation group had a higher CFCP than the other two groups(P＜0.05).The VHI score in the double stimulation group was lower than in the low-frequency group(P＜0.05).After 8 weeks of intervention,except for the low-fre-quency group,the remaining groups had higher levels of BDNF and lower levels of NSE than before stimula-tion(P＜0.05).The double stimulation group had lower NSE levels than the other two groups(P＜0.05).The level of BDNF in the dual stimulation group was higher than the low-frequency group(P＜0.05).After 8 weeks of intervention,except for the psychological dimensions of the low-frequency and high-frequency groups,the scores of the other three groups in all three dimensions of SAQOL-39 were higher than before stimulation(P＜0.05).Inter group comparison showed that the dual stimulation group had higher communication and physiological dimensions than the other two groups(P＜0.05).In terms of clinical efficacy,the total effective rate of the dual stimulation group was 96.97％,which was significantly higher than the high frequency group and the low frequency group(P＜0.05).Conclusion:By comparing the intervention of rTMS on mild and moderate post-stroke motor aphasia with different frequencies and stimulation sites,it was found that the effect of high-frequency rTMS on the left side was equivalent to that of low-frequency rTMS on the right side,and the combined stimulation of the two could enhance the therapeutic effect.关键词
频率/刺激/重复经颅磁刺激/脑卒中/运动性失语Key words
frequency/stimulation/repetitive transcranial magnetic stimulation/stroke/motor aphasia分类
医药卫生引用本文复制引用
浦创,梁凡,杨小玥,徐亚,钱虹..不同频率和刺激部位的重复经颅磁刺激治疗脑卒中后运动性失语的临床研究[J].中国康复,2025,40(7):412-417,6.基金项目
四川省卫生健康科研课题(19SYJS02) （19SYJS02）
