中国康复理论与实践2025，Vol.31Issue(7)：812-821,10.DOI:10.3969/j.issn.1006-9771.2025.07.008
基于运动序列学习探讨高频重复经颅磁刺激对脑卒中患者上肢功能的效果
Effect of high-frequency repetitive transcranial magnetic stimulation on upper limb function of stroke patients based on motor sequence learning
摘要
Abstract
Objective To investigate the effects of high-frequency repetitive transcranial magnetic stimulation(HF-rTMS)applied to the supplementary motor area(SMA)or primary motor cortex(M1)on upper limb function in stroke patients in terms of motor sequence learning. Methods From April,2024 to February,2025,60 inpatients were recruited from the First Affiliated Hospital with Nan-jing Medical University.They were randomly assigned into the control group,SMA group and M1 group,with 20 patients in each group.All the groups received medication and conventional rehabilitation.On this basis,SMA group underwent HF-rTMS on the affected side's SMA,while M1 group received HF-rTMS on the affected side's M1 for two weeks.All the groups were measured with motor evoked potentials(MEP),the serial reaction time(RT)task,Fugl-Meyer Assessment-Upper Extremities(FMA-UE)and modified Barthel Index(MBI)before and after intervention. Results The SMA and M1 groups dropped one case respectively.MEP elicitation rate of the affected side's increased in SMA and M1 groups(P<0.05),and it was better than that in the control group(χ²>4.792,P<0.05).The intra-group effects of RTsequential sequence,FMA-UE and MBI scores were significant(|F|>81.546,P<0.05).The inter-group effects of RTrandom sequence,RTsequential sequence,∆RT,and MBI scores were significant(F>3.228,P<0.05).The in-teractive effects of RTrandom sequence,RTsequential sequence,∆RT,FMA-UE and MBI scores were significant(|F|>3.520,P>0.05).After intervention,RTsequential sequence,∆RT,FMA-UE and MBI scores improved(P<0.05).RTrandom sequence was lower in SMA group than in the control group(P<0.017),RTsequential sequence,∆RT,FMA-UE and MBI scores im-proved more in SMA and M1 groups than in the control group(P<0.05),but no significant difference was found between the SMA group and the M1 group(P>0.05). Conclusion HF-rTMS applied to the affected SMA or M1 can activate motor sequence learning and promote the recov-ery of upper limb function in stroke patients.关键词
脑卒中/运动序列学习/重复经颅磁刺激/辅助运动区/初级运动皮质/上肢Key words
stroke/motor sequence learning/repetitive transcranial magnetic stimulation/supplementary motor area/primary motor cortex/upper limbs分类
医药卫生引用本文复制引用
孙婉婷,许光旭,艾丽皮乃·亚森,龚翔,肖悦,甘兆丹,刘铭洁,曾兰婷,马姝玥,鲁俊..基于运动序列学习探讨高频重复经颅磁刺激对脑卒中患者上肢功能的效果[J].中国康复理论与实践,2025,31(7):812-821,10.基金项目
苏州市姑苏卫生人才项目(No.GWSW2022073) Suzhou Gusu Health Talent Project(No.GWSW2022073) （No.GWSW2022073）
