切换至 "中华医学电子期刊资源库"

中华脑科疾病与康复杂志(电子版) ›› 2023, Vol. 13 ›› Issue (02) : 118 -123. doi: 10.3877/cma.j.issn.2095-123X.2023.02.009

综述

重复经颅磁刺激技术在颅脑外伤康复中的研究进展
潘升超, 陈燕, 余程冬, 曹晓光()   
  1. 230011 合肥市第二人民医院(安徽医科大学附属合肥医院)康复医学科
    230011 合肥,安徽医科大学第一附属医院高新院区小儿神经康复中心
  • 收稿日期:2022-05-23 出版日期:2023-04-15
  • 通信作者: 曹晓光

Research progress of repetitive transcranial magnetic stimulation in the rehabilitation of traumatic brain injury

Shengchao Pan, Yan Chen, Chengdong Yu, Xiaoguang Cao()   

  1. Department of Rehabilitation Medicine, The Second People's Hospital of Hefei (Hefei Hospital Affiliated to Anhui Medical University), Hefei 230011, China
    Pediatric Neurorehabilitation Center, High tech Hospital District, the First Affiliated Hospital of Anhui Medical University, Hefei 230011, China
  • Received:2022-05-23 Published:2023-04-15
  • Corresponding author: Xiaoguang Cao
引用本文:

潘升超, 陈燕, 余程冬, 曹晓光. 重复经颅磁刺激技术在颅脑外伤康复中的研究进展[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(02): 118-123.

Shengchao Pan, Yan Chen, Chengdong Yu, Xiaoguang Cao. Research progress of repetitive transcranial magnetic stimulation in the rehabilitation of traumatic brain injury[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(02): 118-123.

颅脑外伤(TBI)后功能障碍使患者的生活质量下降,给社会及家庭带来沉重的负担。重复经颅磁刺激(rTMS)是一种非侵入性脑刺激技术,通过脉冲磁场作用于中枢神经系统(主要是大脑),改变皮质神经细胞的膜电位,产生感应电流,影响脑内代谢和神经电活动,从而引起一系列生理生化反应。本文围绕rTMS技术的基本原理、TBI中的应用情况以及使用安全性的研究进展作一综述。

The functional disorder after traumatic brain injury (TBI) reduces the quality of life of patients, and brings a heavy burden to their families and society. Repetitive transcranial magnetic stimulation is a non-invasive brain stimulation technology. Pulsed magnetic field acts on the central nervous system (mainly the brain), changes the membrane potential of cortical nerve cells, makes them produce induced current, affects brain metabolism and electroneural activities, and then causes a series of physiological and biochemical reactions. This article reviews the basic principle of rTMS technique, the application of rTMS in craniocerebral trauma and the research progress of usage security.

[1]
Gardner AJ, Zafonte R. Neuroepidemiology of traumatic brain injury[J]. Handb Clin Neurol, 2016, 138: 207-223. DOI: 10.1016/B978-0-12-802973-2.00012-4.
[2]
夏照帆,伍国胜.创伤性脑损伤的临床研究进展[J].第二军医大学学报, 2021, 42(2): 117-121. DOI: 10.16781/j.0258-879x.2021.02.0117.
[3]
Barker AT, Jalinous R, Freeston IL. Non-invasive magnetic stimulation of human motor cortex[J]. Lancet, 1985, 1(8437): 1106-1107. DOI: 10.1016/s0140-6736(85)92413-4.
[4]
上海市康复医学会.经颅磁刺激技术操作指南: T/SRMA 5-2019[S].上海:上海市康复医学会标准化工作办公室, 2019.
[5]
董心,郑洁皎,许光旭,等.《经颅磁刺激操作指南》团体标准解读[J].中国标准化, 2021, 24(14): 89-93. DOI: 10.3969/j.issn.1002-5944.2021.14.024.
[6]
Dang B, Chen W, He W, et al. Rehabilitation treatment and progress of traumatic brain injury dysfunction[J]. Neural Plast, 2017, 2017: 1582182. DOI: 10.1155/2017/1582182.
[7]
倪莹莹,王首红,宋为群,等.神经重症康复中国专家共识(中)[J].中国康复医学杂志, 2018, 33(1): 7-14. DOI: 10.3969/j.issn.1001-1242.2018.01.003.
[8]
Ianof JN, Anghinah R. Traumatic brain injury: an EGG point of view[J]. Dement Neuropsychol, 2017, 11(1): 3-5. DOI: 10.1590/1980-57642016dn11-010002.
[9]
Anandalwar SP, Mau CY, Gordhan CG, et al. Eliminating unnecessary routine head CT scanning in neurologically intact mild traumatic brain injury patients: implementation and evaluation of a new protocol[J]. J Neurosurg, 2016, 125(3): 667-673. DOI: 10.3171/2015.9.JNS151379.
[10]
Emami P, Czorlich P, Fritzsche FS, et al. Impact of Glasgow Coma Scale score and pupil parameters on mortality rate and outcome in pediatric and adult severe traumatic brain injury: a retrospective, multicenter cohort study[J]. J Neurosurg, 2017, 126(3): 760-767. DOI: 10.3171/2016.1.JNS152385.
[11]
Capizzi A, Woo J, Verduzco-Gutierrez M. Traumatic brain injury: an overview of epidemiology, pathophysiology, and medical management[J]. Med Clin North Am, 2020, 104(2): 213-238. DOI: 10.1016/j.mcna.2019.11.001.
[12]
Bai Y, Xia X, Kang J, et al. Evaluating the effect of repetitive transcranial magnetic stimulation on disorders of consciousness by using TMS-EEG[J]. Front Neurosci, 2016, 10: 473. DOI: 10.3389/fnins.2016.00473.
[13]
白洋.意识障碍的脑电分析与神经调控评估[D].秦皇岛:燕山大学, 2017.
[14]
何任红.重复经颅磁刺激在意识障碍患者康复中的临床研究[D].广州:南方医科大学, 2021.
[15]
Fan J, Zhong Y, Wang H, et al. Repetitive transcranial magnetic stimulation improves consciousness in some patients with disorders of consciousness[J]. Clin Rehabil, 2022, 36(7): 916-925. DOI: 10.1177/02692155221089455.
[16]
沈龙彬,欧阳辉,杨承佑,等.高频重复经颅磁刺激对重症颅脑损伤后意识障碍的促醒疗效[J].中国康复医学杂志, 2019, 34(12): 1411-1417. DOI: 10.3969/j.issn.1001-1242.2019.12.004.
[17]
Manganotti P, Formaggio E, Storti SF, et al. Effect of high-frequency repetitive transcranial magnetic stimulation on brain excitability in severely brain-injured patients in minimally conscious or vegetative state[J]. Brain Stimul, 2013, 6(6): 913-921. DOI: 10.1016/j.brs.2013.06.006.
[18]
Piccione F, Cavinato M, Manganotti P, et al. Behavioral and neurophysiological effects of repetitive transcranial magnetic stimulation on the minimally conscious state: a case study[J]. Neurorehabil Neural Repair, 2011, 25(1): 98-102. DOI: 10.1177/1545968310369802.
[19]
Naro A, Russo M, Leo A, et al. A single session of repetitive transcranial magnetic stimulation over the dorsolateral prefrontal cortex in patients with unresponsive wakefulness syndrome: preliminary results[J]. Neurorehabil Neural Repair, 2015, 29(7): 603-613. DOI: 10.1177/1545968314562114.
[20]
吴伟鹏,许思宾,苏标瑞,等.纳美芬联合高频重复经颅磁刺激对创伤性颅脑损伤后昏迷患者意识恢复及血清水通道蛋白-1、血管生成素1水平的影响[J].广西医学, 2022, 44(17): 2045-2049. DOI: 10.11675/j.issn.0253-4304.2022.17.20.
[21]
吕超,费舟,胡学安,等.低频重复经颅磁刺激对颅脑损伤后植物状态患者的促醒作用[J].中国医药导报, 2016, 13(17): 69-72.
[22]
de Freitas Cardoso MG, Faleiro RM, de Paula JJ, et al. Cognitive impairment following acute mild traumatic brain injury[J]. Front Neurol, 2019, 10: 198. DOI: 10.3389/fneur.2019.00198.
[23]
张雪茹,郝习君,李朝征,等.脑外伤患者认知功能障碍的危险因素[J].中国康复理论与实践, 2022, 28(2): 212-219. DOI: 10.3969/j.issn.1006-9771.2022.02.012.
[24]
Lee SA, Kim MK. Effect of low frequency repetitive transcranial magnetic stimulation on depression and cognition of patients with traumatic brain injury: a randomized controlled trial[J]. Med Sci Monit, 2018, 24: 8789-8794. DOI: 10.12659/MSM.911385.
[25]
王俊伟.高频重复经颅磁刺激对中型颅脑损伤后认知功能障碍患者的影响[D].新乡:新乡医学院, 2019.
[26]
王单,麦荣康,王敏,等.健侧重复经颅磁刺激对脑外伤患者记忆和生活质量的影响[J].中国康复理论与实践, 2017, 23(10): 1180-1184. DOI: 10.3969/j.issn.1006-9771.2017.10.012.
[27]
韩凯月,党辉,张皓.重复经颅磁刺激治疗脑外伤患者认知障碍的Meta分析[J].中国康复理论与实践, 2021, 27(11): 1282-1290. DOI: 10.3969/j.issn.1006-9771.2021.11.007.
[28]
李海宁,陈英道,黄敏,等.重复经颅磁刺激对脑卒中后认知功能障碍患者认知功能、中枢运动传导时间及平衡能力的影响[J].中国康复, 2023, 38(3): 140-143. DOI: 10.3870/zgkf.2023.03.003.
[29]
Liu M, Bao G, Bai L, et al. The role of repetitive transcranial magnetic stimulation in the treatment of cognitive impairment in stroke patients: a systematic review and meta-analysis[J]. Sci Prog, 2021, 104(2): 368504211004266. DOI: 10.1177/00368504211004266.
[30]
尹贻锟,王佳林,孙君志.不同频率重复经颅磁刺激对脑卒中后认知障碍疗效的Meta分析[J].中国组织工程研究, 2023, 27(20): 3274-3280. DOI: 10.12307/2023.150.
[31]
樊衍孜,吕亚婷.重复经颅磁刺激作用的脑机制研究进展[J].杭州师范大学学报(自然科学版), 2022, 21(3): 254-260. DOI: 10.19926/j.cnki.issn.1674-232X.2022.03.004.
[32]
杨初燕.康复治疗对脑外伤后意识及认知障碍的临床和机制研究[D].南昌:南昌大学, 2016.
[33]
Arnould A, Dromer E, Rochat L, et al. Neurobehavioral and self-awareness changes after traumatic brain injury: towards new multidimensional approaches[J]. Ann Phys Rehabil Med, 2016, 59(1): 18-22. DOI: 10.1016/j.rehab.2015.09.002.
[34]
宋宏飞,邓茜,杨宁,等.脑外伤所致精神障碍者冲动控制能力及ERP特征[J].法医学杂志, 2020, 36(3): 326-332. DOI: 10.12116/j.issn.1004-5619.2020.03.006.
[35]
张贵丽,刘帅,任志宏,等.不同类型轻度认知障碍的认知损害及精神行为症状的比较分析研究[J].中风与神经疾病杂志, 2015, 32(3): 214-219.
[36]
赵春梅,倪莹莹,邱承尧,等.高低频率重复经颅磁刺激对脑外伤后认知功能影响的随机对照研究[J].中国康复, 2020, 35(6): 287-290. DOI: 10.3870/zgkf.2020.06.002.
[37]
McClintock SM, Reti IM, Carpenter LL, et al. Consensus recommendations for the clinical application of repetitive transcranial magnetic stimulation (rTMS) in the treatment of depression[J]. J Clin Psychiatry, 2018, 79(1): 16cs10905. DOI: 10.4088/JCP.16cs10905.
[38]
郭君,李晓丽,关晨霞.低频重复经颅磁刺激对颅脑损伤患者躁狂症状的影响[J].中华物理医学与康复杂志, 2019, 41(8): 598-600. DOI: 10.3760/cma.j.issn.0254-1424.2019.08.011.
[39]
Siddiqi SH, Trapp NT, Shahim P, et al. Individualized connectome-targeted transcranial magnetic stimulation for neuropsychiatric sequelae of repetitive traumatic brain injury in a retired NFL player[J]. J Neuropsychiatry Clin Neurosci, 2019, 31(3): 254-263. DOI: 10.1176/appi.neuropsych.18100230.
[40]
Rodrigues PA, Zaninotto AL, Ventresca HM, et al. The effects of repetitive transcranial magnetic stimulation on anxiety in patients with moderate to severe traumatic brain injury: a post-hoc analysis of a randomized clinical trial[J]. Front Neurol, 2020, 11: 564940. DOI: 10.3389/fneur.2020.564940.
[41]
赵建功,李芮志,徐斌.低频重复经颅磁刺激对重度颅脑外伤术后认知及日常生活能力的疗效分析[J].中国临床医生杂志, 2021, 49(8): 961-964. DOI: 10.3969/j.issn.2095-8552.2021.08.025.
[42]
孙龚卫,杨柳.低频重复经颅磁刺激对脑外伤后认知功能和日常生活活动能力的疗效[J].中国医疗器械信息, 2022, 28(4): 58-60. DOI: 10.15971/j.cnki.cmdi.2022.04.015.
[43]
Shin SS, Krishnan V, Stokes W, et al. Transcranial magnetic stimulation and environmental enrichment enhances cortical excitability and functional outcomes after traumatic brain injury[J]. Brain Stimul, 2018, 11(6): 1306-1313. DOI: 10.1016/j.brs.2018.07.050.
[44]
陈柱,徐倩,单春雷.不同频率重复经颅磁刺激治疗Wernicke失语患者的个案报告[J].中国听力语言康复科学杂志, 2020, 18(1): 37-40. DOI: 10.3969/j.issn.1672-4933.2020.01.010.
[45]
Paxman E, Stilling J, Mercier L, et al. Repetitive transcranial magnetic stimulation (rTMS) as a treatment for chronic dizziness following mild traumatic brain injury[J]. BMJ Case Rep, 2018, 2018: bcr2018226698. DOI: 10.1136/bcr-2018-226698.
[46]
Choi GS, Kwak SG, Lee HD, et al. Effect of high-frequency repetitive transcranial magnetic stimulation on chronic central pain after mild traumatic brain injury: a pilot study[J]. J Rehabil Med, 2018, 50(3): 246-252. DOI: 10.2340/16501977-2321.
[47]
Lefaucheur JP, André-Obadia N, Antal A, et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS)[J]. Clin Neurophysiol, 2014, 125(11): 2150-2206. DOI: 10.1016/j.clinph.2014.05.021.
[48]
李春虎,郑全乐,付娜,等.高压氧治疗颅脑外伤患者246例的临床疗效分析[J].中华神经创伤外科电子杂志, 2018, 4(1): 13-15. DOI: 10.3877/cma.j.issn.2095-9141.2018.01.004.
[49]
章良翔,倪莹莹,邓丽霞,等.高频rTMS、脑仿生电及其序贯治疗脑外伤持续植物状态患者的临床观察[J].中国康复, 2021, 36(1): 21-25. DOI: 10.3870/zgkf.2021.01.005.
[50]
岳璠.重复经颅磁刺激联合计算机辅助认知功能训练对颅脑损伤后认知障碍的疗效观察[D].郑州:郑州大学, 2019.
[51]
赵晓坤,周俊杰,张倩倩.低频重复经颅磁刺激联合有氧运动训练对脑外伤后认知障碍患者认知功能的影响[J].中国疗养医学, 2021, 30(7): 706-708. DOI: 10.13517/j.cnki.ccm.2021.07.012.
[52]
欧海荣,梁仔,李越,等.基于颅脑外伤患者认知障碍特点的临床治疗对策[J].中华脑科疾病与康复杂志(电子版), 2019, 9(5): 293-296. DOI: 10.3877/cma.j.issn.2095-123X.2019.05.009.
[53]
周天鹏,张广浩,吴昌哲,等.经颅磁刺激定位方法的研究进展[J].中国生物医学工程学报, 2017, 36(6): 741-748. DOI: 10.3969/j.issn.0258-8021.2017.06.015.
[54]
邱轶慧,高玉元,聂坤,等.重复经颅磁刺激治疗帕金森病抑郁的相关进展[J].中华神经科杂志, 2018, 51(3): 208-211. DOI: 10.3760/cma.j.issn.1006-7876.2018.03.012.
[55]
Pereira LS, Müller VT, da Mota Gomes M, et al. Safety of repetitive transcranial magnetic stimulation in patients with epilepsy: a systematic review[J]. Epilepsy Behav, 2016, 57(Pt A): 167-176. DOI: 10.1016/j.yebeh.2016.01.015.
[56]
Nielson DM, McKnight CA, Patel RN, et al. Preliminary guidelines for safe and effective use of repetitive transcranial magnetic stimulation in moderate to severe traumatic brain injury[J]. Arch Phys Med Rehabil, 2015, 96(4 Suppl): S138-S144. DOI: 10.1016/j.apmr.2014.09.010.
[57]
Pink AE, Williams C, Alderman N, et al. The use of repetitive transcranial magnetic stimulation (rTMS) following traumatic brain injury (TBI): a scoping review[J]. Neuropsychol Rehabil, 2021, 31(3): 479-505. DOI: 10.1080/09602011.2019.1706585.
[1] 熊倩, 罗凤. 乳腺癌患者术后康复现状与对策的研究进展[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 372-374.
[2] 董红华, 郭艮春, 江磊, 吴雪飞, 马飞翔, 李海凤. 骨科康复一体化模式在踝关节骨折快速康复中的应用[J]. 中华关节外科杂志(电子版), 2023, 17(06): 802-807.
[3] 豆艺璇, 黄怀, 钱绮雯, 邢然然, 林丽, 白建芳. 低强度吸气肌训练对机械通气患者肺康复的影响[J]. 中华危重症医学杂志(电子版), 2023, 16(05): 370-375.
[4] 李晓阳, 刘柏隆, 周祥福. 大数据及人工智能对女性盆底功能障碍性疾病的诊断及风险预测[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(06): 549-552.
[5] 李腾成, 谭益元, 黄群雄, 吴杰英, 肖恒军, 胡成, 李茂胤, 高新, 狄金明. 机器人腹腔镜后入路完全筋膜内根治性前列腺切除术治疗早期前列腺癌[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(05): 452-456.
[6] 李雪, 刘文婷, 窦丽婷, 刘叶红. 联合护理在腹腔镜食管裂孔疝修补中的应用效果分析[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 750-754.
[7] 郑华蓉, 刘俊, 郑艳, 陈玉莲, 廖子敏. 加速康复外科理念下的集束化护理模式在腹股沟疝修补术中的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(05): 643-646.
[8] 丁晨梦, 胡雪慧, 闫沛, 程乔. 髋部骨折术后患者居家康复体验质性研究的Meta整合[J]. 中华老年骨科与康复电子杂志, 2023, 09(06): 365-372.
[9] 中华医学会骨科分会关节学组. 中国髋、膝关节置换日间手术围手术期管理专家共识[J]. 中华老年骨科与康复电子杂志, 2023, 09(06): 321-332.
[10] 李美娜, 宋艳丽, 杨姗姗, 李聚彩, 罗慧利, 吕杰. 三联预康复策略在退行性脊柱侧弯患者围术期的应用效果[J]. 中华老年骨科与康复电子杂志, 2023, 09(06): 356-364.
[11] 顾国英, 黄迎春, 刘佳, 居建明, 于国锋, 蒋荣. 个体化肠外营养在肠切除伴肠功能障碍患者中的应用研究[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 489-493.
[12] 陆猛桂, 黄斌, 李秋林, 何媛梅. 蜂蛰伤患者发生多器官功能障碍综合征的危险因素分析[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1010-1015.
[13] 李岩松, 李涛, 张元鸣飞, 李志鹏, 周谋望. 头戴式虚拟现实设备辅助全膝关节置换术后康复的初步研究[J]. 中华临床医师杂志(电子版), 2023, 17(06): 676-681.
[14] 潘惠, 王明, 杨忠, 杜向东. 低频重复经颅磁刺激辅助治疗伴不同特征抑郁症的对照研究[J]. 中华临床医师杂志(电子版), 2023, 17(05): 562-568.
[15] 刘感哲, 艾芬. MiRNA-210通过抑制HIF-1α的表达改善大鼠血管性认知功能障碍[J]. 中华脑血管病杂志(电子版), 2023, 17(05): 489-494.
阅读次数
全文


摘要