脑经颅磁刺激在卒中康复中的应用
杂志全名及年卷期：Expert Rev Neurother. 2007 Mar;7(3):249-58.文题：Use of transcranial magnetic stimulation of the brain in stroke rehabilitation
PMID:17341173
作者： Profice P, Pilato F, Dileone M, Ranieri F, Capone F, Musumeci G, A Tonali P, Di Lazzaro V.
Use of transcranial magnetic stimulation of the brain in stroke rehabilitation
脑经颅磁刺激在卒中康复中的应用
Preliminary studies suggest that stimulation of the motor cortex enhances motor recovery after stroke. Most of these studies employed transcranial magnetic stimulation of the brain and two different approaches have been evaluated. The first approach is based on the use of protocols of stimulation that increase cortical excitability, targeting the hemisphere in which the stroke occurred in order to enhance the output of the motor cortex and the response to physiotherapy. The second approach is based on the use of protocols of stimulation that suppress cortical excitability, targeting the intact hemisphere in order to counteract the imbalance due to the increased interhemispheric inhibition onto the lesioned cortex, and reducing the potential negative interference of the intact hemisphere with the function of the affected one. Cumulatively, preliminary studies suggest that transcranial magnetic stimulation might be a suitable method to combine with physiotherapy and improve recovery of useful limb function in stroke patients. However, further studies are needed to determine the best stimulation parameters and how to select patients who are likely to respond to this treatment.
初步研究表明运动皮质的刺激增强卒中后的运动康复。这些研究中大多数采用脑经颅磁刺激来评价两种不同的方法。第一种方法是建立在刺激能够增强皮质的兴奋性这样的刺激设计应用，目标是卒中发生侧半球，来增强运动皮质的输出和对理疗的应答。第二种方法是建立在抑制皮质的兴奋性这样的刺激设计应用，目标是未受累侧半球，来阻碍由于受损皮质半球内抑制而增强的不平衡，减少未受累半球对受累侧功能潜在的负干扰。总之，初步研究表明经颅磁刺激可能是一种联合理疗、能改善卒中病人有用肢体的康复的合适的方法。然而，需要进一步的研究来证实最好的刺激参数和怎样选择可能对这种治疗反应的病人。
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