Te Efect of Repetitive Transcranial Magnetic Stimulation on Spasticity in Patients with Multiple Sclerosis
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background and Purpose Tis randomized controlled study examined the efect of repetitive transcranial magnetic stimulation (rTMS) on spasticity in patients with multiple sclerosis (MS). Methods Tis study included 16 patients with a history of MS and spasticity in the adductor hip muscles according to the Modifed Ashworth Scale (MAS). Te participants were randomized into the active group (n=10) and control group (n=6), in which active rTMS and sham rTMS were applied in 10 sessions, respectively. A physical therapy and rehabilitation program was applied along with rTMS sessions in both groups. Te evaluation parameters were assessed at baseline and then 1 week and 1 month afer applying rTMS. Results Statistical analyses with post-hoc correction revealed statistically signifcant improvements in the active group compared to the control group in the bilateral MAS score, Penn Spasm Frequency Scale score, patient satisfaction, amount of urine leakage, actual health status, perceived health status, energy and fatigue, role limitations due to physical problems, social function, overall quality of life, cognitive functioning, physical health composite score, mental health composite score, and total score on the Multiple Sclerosis Quality of Life-54 (MSQOL-54) (p< 0.05). Statistically signifcant changes were detected in the MSQOL-54 social function and physical health composite scores of patients in the control group (p<0.05). Conclusions Active rTMS combined with a physical therapy program reduced spasticity in MS patients compared to the control group that received only physical therapy. Further comprehensive and more advanced studies are needed to confrm the present fndings.
Abstract
Background and Purpose Tis randomized controlled study examined the efect of repetitive transcranial magnetic stimulation (rTMS) on spasticity in patients with multiple sclerosis (MS). Methods Tis study included 16 patients with a history of MS and spasticity in the adductor hip muscles according to the Modifed Ashworth Scale (MAS). Te participants were randomized into the active group (n=10) and control group (n=6), in which active rTMS and sham rTMS were applied in 10 sessions, respectively. A physical therapy and rehabilitation program was applied along with rTMS sessions in both groups. Te evaluation parameters were assessed at baseline and then 1 week and 1 month afer applying rTMS. Results Statistical analyses with post-hoc correction revealed statistically signifcant improvements in the active group compared to the control group in the bilateral MAS score, Penn Spasm Frequency Scale score, patient satisfaction, amount of urine leakage, actual health status, perceived health status, energy and fatigue, role limitations due to physical problems, social function, overall quality of life, cognitive functioning, physical health composite score, mental health composite score, and total score on the Multiple Sclerosis Quality of Life-54 (MSQOL-54) (p< 0.05). Statistically signifcant changes were detected in the MSQOL-54 social function and physical health composite scores of patients in the control group (p<0.05). Conclusions Active rTMS combined with a physical therapy program reduced spasticity in MS patients compared to the control group that received only physical therapy. Further comprehensive and more advanced studies are needed to confrm the present fndings.
참고문헌 (30)
- Lassmann H, "Heterogeneity of multiple sclerosis pathogenesis : implications for diagnosis and therapy", Trends Mol Med, 7, pp.115~121 (2001)
- Karabudak R, "Multipl skleroz : bilimsel araştırmalardan tedaviye-multipl sklerozda yeni yönelimler", Hacettepe Tıp Dergisi, 39, pp.115~120 (2008)
- Goldenberg MM, "Multiple sclerosis review", P T, 37, pp.175~184 (2012)
- Chwastiak L, "Depressive symptoms and severity of illness in multiple sclerosis : epidemiologic study of a large community sample", Am J Psychiatry, 159, pp.1862~1868 (2002)
- Rizzo MA, "Prevalence and treatment of spasticity reported by multiple sclerosis patients", Mult Scler, 10, pp.589~595 (2004)
- Beard S, "Treatments for spasticity and pain in multiple sclerosis: a systematic review", Health Technol Assess, 7, pp.iii~111 (2003)
- Özakbaş S, "Multipl Sklerozda Semptomatik Tedavi", Noro Psikiyatr Ars, 48, pp.83~89 (2011)
- Lance JW, "Spasticity, Disordered Motor Control", pp.17~24 (1980), Year Book Medical Publishers
- Richards RG, "A review of the natural history and epidemiology of multiple sclerosis : implications for resource allocation and health economic models", Health Technol Assess, 6, pp.1~73 (2002)
- Iodice R, "The therapeutic use of non-invasive brain stimulation in multiple sclerosis-a review", Restor Neurol Neurosci, 35, pp.497~509 (2017)
- Mori F, "The use of repetitive transcranial magnetic stimulation(rTMS)for the treatment of spasticity", Prog Brain Res, 175, pp.429~439 (2009)
- Palm U, "Non-invasive brain stimulation therapy in multiple sclerosis : a review of tDCS, rTMS and ECT results", Brain Stimul, 7, pp.849~854 (2014)
- Centonze D, "Repetitive transcranial magnetic stimulation of the motor cortex ameliorates spasticity in multiple sclerosis", Neurology, 68, pp.1045~1050 (2007)
- Rossini PM, "Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: basic principles and procedures for routine clinical and research application. An updated report from an I.F.C.N. Committee", Clin Neurophysiol, 126, pp.1071~1107 (2015)
- Centonze D, "Effects of motor cortex rTMS on lower urinary tract dysfunction in multiple sclerosis", Mult Scler, 13, pp.269~271 (2007)
- Ozakbas S, "Correlations between multiple sclerosis functional composite, expanded disability status scale and health-related quality of life during and after treatment of relapses in patients with multiple sclerosis", J Neurol Sci, 218, pp.3~7 (2004)
- Kurtzke JF, "Rating neurologic impairment in multiple sclerosis : an expanded disability status scale(EDSS)", Neurology, 33, pp.1444~1452 (1983)
- Patzold T, "Changes of the MS functional composite and EDSS during and after treatment of relapses with methylprednisolone in patients with multiple sclerosis", Acta Neurol Scand, 105, pp.164~168 (2002)
- Heiskanen S, "Health-related quality of lifetesting the reliability of the MSQOL-54 instrument among MS patients", Scand J Caring Sci, 21, pp.199~206 (2007)
- Read DJ, "The effect of spinal cord stimulation on function in patients with multiple sclerosis", Brain, 103, pp.803~833 (1980)
- Hallett M, "Transcranial magnetic stimulation and the human brain", Nature, 406, pp.147~150 (2000)
- Rossi S, "Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research", Clin Neurophysiol, 120, pp.2008~2039 (2009)
- Siebner HR, "Transcranial magnetic stimulation : new insights into representational cortical plasticity", Exp Brain Res, 148, pp.1~16 (2003)
- Nielsen JF, "Treatment of spasticity with repetitive magnetic stimulation; a double-blind placebo-controlled study", Mult Scler, 2, pp.227~232 (1996)
- Kumru H, "Reduction of spasticity with repetitive transcranial magnetic stimulation in patients with spinal cord injury", Neurorehabil Neural Repair, 24, pp.435~441 (2010)
- Gupta M, "Effect of r-TMS over standard therapy in decreasing muscle tone of spastic cerebral palsy patients", J Med Eng Technol, 40, pp.210~216 (2016)
- Málly J, "Recovery of motor disability and spasticity in poststroke after repetitive transcranial magnetic stimulation(rTMS)", Brain Res Bull, 76, pp.388~395 (2008)
- Mori F, "Transcranial magnetic stimulation primes the effects of exercise therapy in multiple sclerosis", J Neurol, 258, pp.1281~1287 (2011)
- Iodice R, "Anodal transcranial direct current stimulation of motor cortex does not ameliorate spasticity in multiple sclerosis", Restor Neurol Neurosci, 33, pp.487~492 (2015)
- Nielsen JF, "A new treatment of spasticity with repetitive magnetic stimulation in multiple sclerosis", J Neurol Neurosurg Psychiatry, 58, pp.254~255 (1995)