经颅磁刺激在帕金森病患者步态异常中的应用_West China Medical Journal

Authors：

 王玲 ,  彭蓉

四川大学华西医院神经内科（成都 610041）;

Corresponding author：

彭蓉, Email: qrpeng@hotmail.com

Keywords：

经颅磁刺激; 帕金森病; 步态异常

DOI：

10.7507/1002-0179.20150276

Video：

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经颅磁刺激（TMS）是利用变化的高毫安电流产生变化的磁场诱导的感应电场作用于颅内可兴奋组织的过程。TMS以其可进行深部刺激、无痛、非介入等优点，被广泛地应用于帕金森病的研究和治疗中。目前帕金森病患者步态异常发生的病理生理机制尚不清楚，且治疗十分困难。近年来TMS在对帕金森病患者步态异常的研究中得到了较大的进展。现对TMS原理以及在帕金森病患者步态异常研究及治疗中的应用和进展进行综述。

Citation： 王玲, 彭蓉. 经颅磁刺激在帕金森病患者步态异常中的应用. West China Medical Journal, 2015, 30(5): 967-970. doi: 10.7507/1002-0179.20150276 Copy

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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.	吴卓华, 崔立谦, 许启锋, 等. 低频重复经颅磁刺激在帕金森病康复治疗中的应用价值[J]. 中国现代神经疾病杂志, 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.
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10.	吕浩, 唐劲天. 经颅磁刺激技术的研究和进展[J]. 中国医疗器械信息, 2006, 12(5):28-32.
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14.	赵澎, 程焱, 陶华英, 等. 重复经颅磁刺激对帕金森病运动功能及运动诱发电位的影响[J]. 中国临床神经科学, 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.

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. 吴卓华, 崔立谦, 许启锋, 等. 低频重复经颅磁刺激在帕金森病康复治疗中的应用价值[J]. 中国现代神经疾病杂志, 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. 陈琳, 黄红云. 重复经颅磁刺激治疗帕金森病的研究进展[J]. 中国微侵袭神经外科杂志, 2010, 15(1):46-48.
9. 万振宽. 重复经颅磁刺激(含定位导航系统)技术及临床应用[J]. 中国医疗设备, 2011, 26(1):99-101.
10. 吕浩, 唐劲天. 经颅磁刺激技术的研究和进展[J]. 中国医疗器械信息, 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. 赵澎, 程焱, 陶华英, 等. 重复经颅磁刺激对帕金森病运动功能及运动诱发电位的影响[J]. 中国临床神经科学, 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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经颅磁刺激在帕金森病患者步态异常中的应用

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