고빈도 반복 경두부 자기자극이 뇌졸중의 운동 기능에 미치는 영향
The Effect of High Frequency Repetitive Transcranial Magnetic Stimulation on the Motor Function in Post-Stroke Patients
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Objective: To evaluate the effects of high frequency repetitive transcranial magnetic stimulation (rTMS) of the affected hemisphere on the motor recovery and spasticity in chronic post-stroke hemiplegic patients. Method: Thirteen chronic stroke hemiplegic patients were randomized to receive real and sham rTMS. rTMS was carried out 10 times at a frequency of 10 Hz with 10 s stimulation followed by 50 s rest, totalling 1,000 stimulations to the affected primary motor cortex using an intensity of 100% of resting motor threshold of unaffected hemisphere. Median nerve H-reflex, modified Ashworth scale (MAS) at elbow and wrist, and manual function test (MFT) were measured at baseline and after 2 weeks of treatment. Results: High frequency rTMS resulted in increased H- reflex latency and decreased H-reflex amplitude and H/M ratio. Also MAS decreased and MFT score increased after 2 weeks of treatment. Conclusion: High frequency rTMS in the affected motor cortex might facilitate motor recovery and reduce spasticity in chronic stroke patients. (J Korean Acad Rehab Med 2010; 34: 168-173)
Abstract
Objective: To evaluate the effects of high frequency repetitive transcranial magnetic stimulation (rTMS) of the affected hemisphere on the motor recovery and spasticity in chronic post-stroke hemiplegic patients. Method: Thirteen chronic stroke hemiplegic patients were randomized to receive real and sham rTMS. rTMS was carried out 10 times at a frequency of 10 Hz with 10 s stimulation followed by 50 s rest, totalling 1,000 stimulations to the affected primary motor cortex using an intensity of 100% of resting motor threshold of unaffected hemisphere. Median nerve H-reflex, modified Ashworth scale (MAS) at elbow and wrist, and manual function test (MFT) were measured at baseline and after 2 weeks of treatment. Results: High frequency rTMS resulted in increased H- reflex latency and decreased H-reflex amplitude and H/M ratio. Also MAS decreased and MFT score increased after 2 weeks of treatment. Conclusion: High frequency rTMS in the affected motor cortex might facilitate motor recovery and reduce spasticity in chronic stroke patients. (J Korean Acad Rehab Med 2010; 34: 168-173)
참고문헌 (23)
- Málly J, "Recovery of motor disability and spasticity in post-stroke after repetitive transcranial magnetic stimulation (rTMS)", Brain Res Bull, 76, pp.388~395 (2008)
- Duncan PW, "Measurement of motor recovery after stroke. Outcome assessment and sample size requirements", Stroke, 23, pp.1084~1089 (1992)
- Hankey GJ, "Electrostimulation for promoting recovery of movement or functional ability after stroke. Systemic review and meta-analysis", Stroke, 37, pp.2441~2442 (2006)
- Touge T, "Are the after-effects of low-frequency rTMS on motor cortex excitability due to changes in the efficacy of cortical synapses?", Clin Neurophysiol, 112, pp.2138~2145 (2001)
- Peinemann A, "Long lasting increase in corticospinal excitability after 1800 pulses of subthreshold 5 Hz repetitive TMS to the primary motor cortex", Clin Neurophysiol, 115, pp.1519~1526 (2004)
- Chen R, "Depression of motor cortex excitability by low-frequency transcranial magnetic stimulation", Neurology, 48, pp.1398~1403 (1997)
- Di Lazzaro V, "Direct demonstration that repetitive transcranial magnetic stimulation can enhance corticospinal excitability in stroke", Stroke, 37, pp.2850~2853 (2006)
- Kim YH, "Repetitive transcranial magnetic stimulation-induced corticomotor excitability and associated motor skill acquisition in chronic stroke", Stroke, 37, pp.1471~1476 (2006)
- Pomeroy VM, "Transcranial magnetic stimulation and muscle contraction to enhance stroke recovery: a randomized proof- of-principle and feasibility investigation", Neurorehabil Neural Repair, 21, pp.509~517 (2007)
- Talelli P, "Arm function after stroke: neurophysiological correlates and recovery mechanisms assessed by transcranial magnetic stimulation", Clin Neurophysiol, 117, pp.1641~1659 (2006)
- Braddom RL, "Physical medicine and rehabilitation", pp.1191~1192 (2007), Saunders
- Jaberzadeh S, "Between-days reliability of H-reflexes in human flexor carpi radialis", Arch Phys Med Rehabil, 85, pp.1168~1173 (2004)
- Sugawara K, "Facilitation of motor evoked potentials and H reflexes of flexor carpi radialis muscle induced by voluntary teeth clenching", Hum Mov Sci, 21, pp.203~212 (2002)
- Angel RW, "The H reflex in normal, spastic and rigid subjects", Arch Neurol, 9, pp.591~596 (1963)
- Inghilleri M, "Effects of transcranial magnetic stimulation on the H reflex and F wave in the hand muscles", Clin Neurophysiol, 114, pp.1096~1101 (2003)
- Sohn MK, "Modulation of spinal excitability by repetitive transcranial magnetic stimulation of motor cortex", J Korean Assoc EMG-Electrodiagn Med, 9, pp.109~115 (2007)
- Pandyan AD, "A review of the properties and limitations of the Ashworth and modified Ashworth scales as measures of spasticity", Clin Rehabil, 13, pp.373~383 (1999)
- Michimata A, "The manual function test: Norms for 20-to 90-year-olds and effects of age, gender and hand dominance on dexterity", Tohoku J Exp Med, 214, pp.257~267 (2008)
- Berardelli A, "Facilitation of muscle evoked responses after repetitive cortical stimulation in man", Exp Brain Res, 122, pp.79~84 (1998)
- Perez MA, "Short-term adaptations in spinal cord circuits evoked by repetitive transcranial magnetic stimulation, possible underlying mechanisms", Exp Brain Res, 162, pp.202~212 (2005)
- 김성우, "뇌성마비 아동에서 일회성 다부위 신경융해술이 상지 기능에 미치는 효과", Annals of Rehabilitation Medicine, 30(5), pp.462~467 (2006), 대한재활의학회
- Fregni F, "A sham-controlled trial of a 5-day course of repetitive transcranial magnetic stimulation of the unaffected hemisphere in stroke patients", Stroke, 37, pp.2115~2122 (2006)
- Dafotakis M, "Effects of rTMS on grip force control following subcortical stroke", Exp Neurol, 211, pp.407~412 (2008)