經顱磁刺激在帕金森病患者步態異常中的應用_West China Medical Journal

Authors：

 王玲 ,  彭蓉

四川大學華西醫院神經內科（成都 610041）;

Corresponding?author：

彭蓉, Email: qrpeng@hotmail.com

Keywords：

經顱磁刺激; 帕金森病; 步態異常

DOI：

10.7507/1002-0179.20150276

Video：

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經顱磁刺激（TMS）是利用變化的高毫安電流產生變化的磁場誘導的感應電場作用于顱內可興奮組織的過程。TMS以其可進行深部刺激、無痛、非介入等優點，被廣泛地應用于帕金森病的研究和治療中。目前帕金森病患者步態異常發生的病理生理機制尚不清楚，且治療十分困難。近年來TMS在對帕金森病患者步態異常的研究中得到了較大的進展。現對TMS原理以及在帕金森病患者步態異常研究及治療中的應用和進展進行綜述。

Citation： 王玲, 彭蓉. 經顱磁刺激在帕金森病患者步態異常中的應用. West China Medical Journal, 2015, 30(5): 967-970. doi: 10.7507/1002-0179.20150276 Copy

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2.	Morris MF, Mcginley J. The biomechanics and motor control of gait in Parkinson disease[J]. Clin Biomech (Bristol, Avon), 2001, 16(6):459-470.
3.	Elefant C, Baker FA, Lotan M, et al. The effect of group music therapy on mood, speech, and singing in individuals with Parkinson's disease:a feasibility study[J]. J Music Ther, 2012, 49(3):278-302.
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5.	Wu AD, Fregni F, Simon DK, et al. Noninvasive brain stimulation for Parkinson's disease and dystonia[J]. Neurotherapeutics, 2008, 5(2):345-361.
6.	吳卓華, 崔立謙, 許啟鋒, 等. 低頻重復經顱磁刺激在帕金森病康復治療中的應用價值[J]. 中國現代神經疾病雜志, 2013, 13(7):601-605.
7.	Elahi B, Elahi B, Chen R. Effect of transcranial magnetic stimulation on Parkinson motor function:systematic review of controlled clinical trials[J]. Mov Disord, 2009, 24(3):357-363.
8.	陳琳, 黃紅云. 重復經顱磁刺激治療帕金森病的研究進展[J]. 中國微侵襲神經外科雜志, 2010, 15(1):46-48.
9.	萬振寬. 重復經顱磁刺激(含定位導航系統)技術及臨床應用[J]. 中國醫療設備, 2011, 26(1):99-101.
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14.	趙澎, 程焱, 陶華英, 等. 重復經顱磁刺激對帕金森病運動功能及運動誘發電位的影響[J]. 中國臨床神經科學, 2007, 15(4):397-401.
15.	Litvinenko IV, Khalimov RR, Trufanov AG, et al. New approach to gait disorders therapy in late stages of Parkinson's disease[J]. Adv Gerontol, 2012, 25(2):267-274.
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17.	Brunt D, Protas EJ, Bishop M. Gait characteristics and inter-vention strategies in patients with Parkinson's disease[M]//Trail M, Protas EJ, Lai EC. Neurorehabilitation in Parkinson's disease:an evidence-based treatment model. Thorofare:Slack Incorporated, 2008:153-174.
18.	Yang YR, Tseng CY, Chiou SY, et al. Combination of rTMS and treadmill training modulates corticomotor inhibition and improves walking in parkinson disease:a randomized trial[J]. Neurorehabil Neural Repair, 2013, 27(1):79-86.
19.	Rektorova I, Sedlackova S, Telecka SA, et al. Repetitive transcranial stimulation for freezing of gait in Parkinson's disease[J]. Mov Disord, 2007, 22(10):1518-1519.
20.	Del Olmo MF, Bello O, Cudeiro J. Transcranial magnetic stimulation over dorsolateral prefrontal cortex in Parkinson's disease[J]. Clin Neurophysiol, 2007, 118(1):131-139.
21.	Hamada M, Ugawa Y, Tsuji S. High-frequency rTMS over the supplementary motor area improves bradykinesia in Parkinson's disease:subanalysis of double-blind sham-controlled study[J]. J Neurol Sci, 2009, 287(1/2):143-146.
22.	Arias P, Vivas J, Grieve KL, et al. Controlled trial on the effect of 10 days low-frequency repetitive transcranial magnetic stimulation (rTMS) on motor signs in parkinson's disease[J]. Mov Disord, 2010, 25(12):1830-1838.
23.	Lomarev MP, Kim DY, Richardson SP, et al. Safety study of high-frequency transcranial magnetic stimulation in patients with chronic stroke[J]. Clin Neurophysiol, 2007, 118(9):2072-2075.
24.	Carey JR, Evans CD, Anderson DC, et al. Safety of 6-Hz primed low-frequency rTMS in stroke[J]. Neurorehabil Neural Repair, 2008, 22(2):185-192.
25.	Kumar R, Chen R, Ashby P. Safety of transcranial magnetic stimulation in patients with implanted deep brain stimulators[J]. Mov Disord, 1999, 14(1):157-158.

1. Barker AT, Jalinous R, Freeston IL. Non-invasive magnetic stimulation of human motor cortex[J]. Lancet, 1985, 1(8437):1106-1107.
2. Morris MF, Mcginley J. The biomechanics and motor control of gait in Parkinson disease[J]. Clin Biomech (Bristol, Avon), 2001, 16(6):459-470.
3. Elefant C, Baker FA, Lotan M, et al. The effect of group music therapy on mood, speech, and singing in individuals with Parkinson's disease:a feasibility study[J]. J Music Ther, 2012, 49(3):278-302.
4. Pascual-Leone A, Valls-Solé J, Brasil-Neto JP, et al. Akinesia in Parkinson's disease. Ⅱ. Effects of subthreshold repetitive transcranial motor cortex stimulation[J]. Neurology, 1994, 44(5):892-898.
5. Wu AD, Fregni F, Simon DK, et al. Noninvasive brain stimulation for Parkinson's disease and dystonia[J]. Neurotherapeutics, 2008, 5(2):345-361.
6. 吳卓華, 崔立謙, 許啟鋒, 等. 低頻重復經顱磁刺激在帕金森病康復治療中的應用價值[J]. 中國現代神經疾病雜志, 2013, 13(7):601-605.
7. Elahi B, Elahi B, Chen R. Effect of transcranial magnetic stimulation on Parkinson motor function:systematic review of controlled clinical trials[J]. Mov Disord, 2009, 24(3):357-363.
8. 陳琳, 黃紅云. 重復經顱磁刺激治療帕金森病的研究進展[J]. 中國微侵襲神經外科雜志, 2010, 15(1):46-48.
9. 萬振寬. 重復經顱磁刺激(含定位導航系統)技術及臨床應用[J]. 中國醫療設備, 2011, 26(1):99-101.
10. 呂浩, 唐勁天. 經顱磁刺激技術的研究和進展[J]. 中國醫療器械信息, 2006, 12(5):28-32.
11. Weber M, Eisen AA. Magnetic stimulation of the central and peripheral nervous systems[J]. Muscle Nerve, 2002, 25(2):160-175.
12. Vacherot F, Attarian S, Vaugoyeau MA. A motor cortex excitability and gait analysis on Parkinsonian patients[J]. Mov Disord, 2010, 25(16):2747-2755.
13. Khedr EM, Rothwell JC, Shawky OA, et al. Effect of daily repetitive transcranial magnetic stimulation on motor performance in Parkinson's disease[J]. Mov Disord, 2006, 21(12):2201-2205.
14. 趙澎, 程焱, 陶華英, 等. 重復經顱磁刺激對帕金森病運動功能及運動誘發電位的影響[J]. 中國臨床神經科學, 2007, 15(4):397-401.
15. Litvinenko IV, Khalimov RR, Trufanov AG, et al. New approach to gait disorders therapy in late stages of Parkinson's disease[J]. Adv Gerontol, 2012, 25(2):267-274.
16. Lomarev MP, Kanchana S, Bara-Jimenez W, et al. Placebo-controlled study of rTMS for the treatment of Parkinson's disease[J]. Mov Disord, 2006, 21(3):325-331.
17. Brunt D, Protas EJ, Bishop M. Gait characteristics and inter-vention strategies in patients with Parkinson's disease[M]//Trail M, Protas EJ, Lai EC. Neurorehabilitation in Parkinson's disease:an evidence-based treatment model. Thorofare:Slack Incorporated, 2008:153-174.
18. Yang YR, Tseng CY, Chiou SY, et al. Combination of rTMS and treadmill training modulates corticomotor inhibition and improves walking in parkinson disease:a randomized trial[J]. Neurorehabil Neural Repair, 2013, 27(1):79-86.
19. Rektorova I, Sedlackova S, Telecka SA, et al. Repetitive transcranial stimulation for freezing of gait in Parkinson's disease[J]. Mov Disord, 2007, 22(10):1518-1519.
20. Del Olmo MF, Bello O, Cudeiro J. Transcranial magnetic stimulation over dorsolateral prefrontal cortex in Parkinson's disease[J]. Clin Neurophysiol, 2007, 118(1):131-139.
21. Hamada M, Ugawa Y, Tsuji S. High-frequency rTMS over the supplementary motor area improves bradykinesia in Parkinson's disease:subanalysis of double-blind sham-controlled study[J]. J Neurol Sci, 2009, 287(1/2):143-146.
22. Arias P, Vivas J, Grieve KL, et al. Controlled trial on the effect of 10 days low-frequency repetitive transcranial magnetic stimulation (rTMS) on motor signs in parkinson's disease[J]. Mov Disord, 2010, 25(12):1830-1838.
23. Lomarev MP, Kim DY, Richardson SP, et al. Safety study of high-frequency transcranial magnetic stimulation in patients with chronic stroke[J]. Clin Neurophysiol, 2007, 118(9):2072-2075.
24. Carey JR, Evans CD, Anderson DC, et al. Safety of 6-Hz primed low-frequency rTMS in stroke[J]. Neurorehabil Neural Repair, 2008, 22(2):185-192.
25. Kumar R, Chen R, Ashby P. Safety of transcranial magnetic stimulation in patients with implanted deep brain stimulators[J]. Mov Disord, 1999, 14(1):157-158.

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經顱磁刺激在帕金森病患者步態異常中的應用

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