不同频率重复经颅磁刺激治疗脑卒中后失语症的效果观察

目的:探讨不同频率重复经颅磁刺激(Repeated transcranial magnetic stimulation,r TMS)治疗脑卒中后失语症的临床效果。方法:选取2015年10月至2018年10月我院收治的脑卒中后失语症患者80例,采用随机数字表法将患者分为两组,低频组患者给予低频r TMS治疗,高频组患者给予高频r TMS治疗。比较两组患者治疗后的西方失语成套测验(Western Aphasia Battery,WAB)各项评分,治疗前后日常生活交流能力检查(Communicative abilities in daily living test,CADL)评分、视图命名得分及命名反应时间的变化。结果:治疗后,两组患者的自发语言、听理解、命名、复述和失语商(Aphasia quotient,AQ)评分比较均无统计学差异(P0.05);两组CADL评分和视图命名得分均较治疗前显著升高(P0.05),但两组间比较无统计学差异(P0.05);两组命名反应时间均较治疗前显著缩短,且高频组显著短于低频组(P0.05)。结论:高频r TMS与低频r TMS均可显著改善脑卒中后失语症患者的自发语言、听理解、命名、复述及日常生活交流能力,但高频r TMS在缩短命名反应时间方面具有更好的效果。

Effect of Different Frequency of rTMS on the Aphasia after Stroke

ABSTRACT Objective: To investigate the clinical effect of different frequency repeated transcranial magnetic stimulation(rTMS) on the aphasia after stroke. Methods: 80 patients with poststroke aphasia admitted to our hospital from October 2015 to October 2018 were selected. The patients were divided into two groups by the random number table method. Patients in the low-frequency group were treated with low-frequency rTMS, and patients in the high-frequency group were treated with high-frequency rTMS. The scores of the Western Aphasia Battery(WAB) after treatment, the changes of communicative abilities in daily living test (CADL) score, view naming score and naming response time before and after treatment were compared between the two groups. Results: After treatment, there was no significant difference in the spontaneous language, listening comprehension, naming, retelling and AQ scores between the two groups (P>0.05). The CADL score and view naming score in both groups were significantly higher than those before treatment (P<0.05), but there was no significant difference between the two groups (P>0.05). The naming reaction time of both groups were significantly shorter than those before treatment, which was significantly shorter in the high frequency group than that of the low frequency group (P<0.05). Conclusion: Both high-frequency rTMS and low-frequency rTMS can significantly improve the spontaneous language, listening comprehension, naming, retelling and daily communication ability of aphasia patients after stroke, but high-frequency rTMS has a better effect in shortening the naming response time.