摘要
目的:探讨不同频率重复经颅磁刺激(rTMS)治疗抽动障碍(TD)患儿的临床疗效。方法:共选取40例确诊TD患儿,随机分为高频率组20例和低频率组20例。采用rTMS刺激于TD患儿大脑左、右额极区(FP1, FP2),刺激频率为高频组15 Hz,低频组1 Hz,脉冲数均为90脉冲/次,3次/天,每次脉冲间隔15 s,刺激强度为45%静息阈值(RMT),连续治疗8天,停2天为一个疗程,持续治疗三个疗程(一个月)。在治疗前、治疗1月和治疗后6个月,两组患儿的病情严重程度用YGTSS量表评估;治疗1月和治疗后6月组临床疗效采用CGI-ei评价。并记录不良反应。结果:治疗前,高频率组与低频率组患儿相比,YGTSS评分差异无统计学意义(P > 0.05);治疗1月组及治疗后6月组:YGTSS评分高频组均低于低频组,差异有统计学意义(P < 0.01);CGI-ei评分高频组均高于低频组,且差异有统计学意义(P < 0.01)。两组临床症状均明显改善。结论:1) 高频率组(15 Hz)与低频率组(1 Hz),治疗1个月结果显示对患儿临床抽动症状(包括抽动形式、次数、强度、频率)均有明显改善;YGTSS评分和CGI-ei评分均显示rTMS治疗TD患儿有良好效果。2) 治疗1月及治疗后6月组的两种评分显示,rTMS的高频刺激较低频刺激治疗效果更加明显。3) 两组患儿在治疗及随访中均未见明显不良反应。
Objective: To investigate the clinical efficacy of different frequency repetitive transcranial magnetic stimulation (rTMS) in the treatment of tic disorder (TD) in children. Methods: A total of 40 children diagnosed with TD were selected and randomly divided into high frequency group (20 cases) and low frequency group (20 cases). rTMS was used to stimulate the left and right frontal polar regions (FP1, FP2) of the brain of the children with TD. The stimulation frequency was 15 Hz in the high frequency group and 1 Hz in the low frequency group. The pulse number was 90 pulses per time, 3 times per day, the interval of each pulse was 15 s, and the stimulation intensity was 45% resting threshold (RMT), continuous treatment for 8 days, stopping for 2 days as a course of treatment, and continuous treatment for three courses (one month). YGTSS scale was used to evaluate the severity of the disease in the two groups before treatment, 1 month and 6 months after treatment. The clin-ical efficacy of 1 month and 6 months after treatment was evaluated by CGI-ei. Adverse reactions were recorded. Results: Before treatment, there was no significant difference in YGTSS scores be-tween the high frequency group and the low frequency group (P > 0.05);1 month treatment group and 6 months after treatment group: YGTSS score in the high frequency group was lower than that in the low frequency group, and the difference was statistically significant (P < 0.01). CGI-ei scores in high frequency group were higher than those in low frequency group, and the difference was statis-tically significant (P < 0.01). The clinical symptoms of both groups were significantly improved. Con-clusions: 1) The frequency 15 Hz (high frequency) or 1 Hz (low frequency) group treated for 1 month, showed that the clinical tic symptoms (including tic form, frequency, intensity, frequency) in children have improved significantly, YGTSS scores and CGI-ei scores showed that rTMS treatment of TD children is effective. 2) The two scores of treatment 1 month of treatment and 6 months after treatment showed that rTMS treatment with high frequency stimulation is more effective for lower frequency stimulation and the improvement of clinical symptoms was more prominent. 3) No sig-nificant adverse reactions were seen in the two groups during treatment and follow-up.
出处
《临床医学进展》
2022年第12期10965-10972,共8页
Advances in Clinical Medicine
