经颅磁刺激在脑卒中康复治疗中的应用-陈瑞全

20014620811··`,2△(1.;2.):、。70%80%,,,,,,。,:,,,,;,。:;:R3382:ADol:103969j/ssn.1671314120154230,10%,。19861990:217l/0l[]。,,z[]。1985,shiifeldAnthonyBarker:,,,,。(erePittiverTanscar-nialMagnetiCstimulation,rTMS)TMS,rTMSTMS。(rTanscranialMagneti。stimulation,TMs),,「34]。。11.1rTMS,rTMS。,,。rTMS,,,。rTMS,,,「56]。:TMS(IH:),;rTMS,,v[]。aJmeSetal[6]2,,10。rTMS(Ml)。fMRI。rFegnietal25TMS,2:(ZO15fy。。1),,,,,:,,,,,,:。B。991。。t。l8[]rTMs,123,,1Hz,。,,。,,,,。rTMS,。iIm10HzrTMS63.5Ml,rTMS,。MEP9[]。rTMS,;TMS,,。rTMS,,,。rTMS(Ml)。,,,l0[”]。:TMS,,,,,l[2]。1.2l[3]。,,,,,。rTMSrTMS,rTMS,[,4]。vlada,。t。l[,4]45,23(10Hz))rTMS,22(IHz):TMS,10,。O’Reardonetal[,5]1010HzrTMS,100%,12/,40,7,3。Kozeletal[,6]rTMS2,TMS。,rTMSrTMS,l[3’7]。26rldLtaestMedicienInofmrtiaon(ElecrtoniceVrsion)2105oVl.15No.462800DFA「4,8]。rTMS、,ls[’4]。1.31/3,,l[9]。:TMS、、,。,,,0z[]。,23,1,l9[2’]。,l[9]。Jerzyetalllg]rTMs8,Broca,10,6,,fMRIBroca。,Borca。,,,,,。:TMS,0z[]。rTMS,;、,,[,3’4,,92。]。1.4,。rTMs(10Hz/15Hz/20Hz),80%110%,10,,,rTMSrTMS,1020h:。:TMS,。rTMS,:1、:,,。,。2、/,。3、。1.5TMS,TMS,。,,,,。,,,,,,。、,fTMS#[]。、、、、、、、,6z[]。,:TMS、、。10Hz,。,rTMS。,rTMS,,,TMS。rTMS,25。3、、,。TMS,。:1、、。2、,,MRITMS,TMS。3、,、、。4、[4,2526]。[:,20083[2]IjikaonesNL,Ba::ettAM.,etalehabilitatio-neme:gngtechnologes,innovativethe:apies,andtu:eobjectives]Neu:othe:eutics,2011,8:52-62.}3]NatashaR,LakshmiNR,LevinsonAJ,etalnhibitionoftheco:texusingtanscanialmaeticstimulationinpsychiaticpopulations:cuentandutuedi:ections]Jpsychiat:yNeu:osci,2012,37(6):369.,2010,16(2):9115j[,,,,2。,16(6):8}6]Ca:eyJR,Ande:sonDC,GillickBT,etalHzp:imedlowequency:TMStocont:alesionalMlin0casesthmiddlece:eb:ala:te:yst:oke]NeuosciLett,2010,69(3):33838.}7]NadiaB,TonyRT:ansc:anialmaeticstimulation:disptingneu:alactivitytoalte:andassessb:ainnction]TheJou:nalofNeu:oscience,2010,30(29):9679650.,,,],2010,23(6):1892.,,2010,19(6):50350.}10]DimyanMA,CohenLG,etal￡ont:ibutionoft:ansc:anialmagneticstimulationtotheundestandingofmechanismsofcntionalecoveyaest:oke]Neu:o:ehabilNeu:aleRpai:,2010,2(2):125135.s。HJ,hKK,SangEK,etl:edictionofmoto:nctionecoveyaesubco:ticalst:oke:Casese:iesofactivationpETandTMSstudies]AnneRhabilMed,2012,36:501511,,,,20,27(6):9.,,,2010,2(2):828VladasV,GiediusG,KastytisDlectophysiologcaldiencesbeeen2rTMS、、2010462081147}12]}15]}22][16]}23]}17][2]25[j[18][19]hiandlowequency:TMpS:otocolsindep:essionta:etment]ctaNeuobiolE,2012,72:283295.BiswadipC,NandK,ShaileshJoleof:epetitivetanscanialmaetiCstimulationinmaintenanc。t:eatmentof:esistantdep:ession]IndianJpsycholMed,2012,3(3):286289.KozelFA,JohnsonKA,ZiadN,etal.Ractionalanisot:opy(FA)chansae:seve:alweeksofdailylehiequencyMSofthep:eontalco:textot:eatmajo:dep:ession]JECT,2011,27(1):510.KainaKK,VikamR,Gegp,etal￡ognitivecoelatesofepetitivet:ansc:anialmaeticstimulation(MS)int:eatment:esistantdep:ession-apilotstu]BMCpsychiat:y,2012,12:163.HeikoU,LauaK,Eichs,etalItahighequencylepeontaltanscanialmaeticstimulationasauentationinseveely111patientsthdep:ession:anatu:alisticshamcont:olled,doubleblind,:andomizedt:ial]Neuopsychobiolo,2012,66:12.szaa:skiJP,Jenni:V,SW,etalxcitato:y:epetitivet:ansc:anialmagneticstimulationinducesimpovementsinchonicpoststokeaphasia]MedSciMonit,2011,17(3):132139.,,,BOLDRlMs],2009,9(33):o1.}27][20]HamiltonRH,ChysikouEG,BanchCechanismsofaphasiaecovewae:st:okeandthe:oleofnoninvasiveb:ainstimulation]:ainLang,2011,118(12):050.Bi:gtG,pete:F,ThomasW￡oitiveectsofhiequency:epetitivet:ansc:anialmaeticstimulation:asystematic:eview]JNeu:alT:ansm,2010,117:105122.SiebneHR,GesaH,TanjaK,etalowdoestanscanialmagneticstimulationmodineu:onalactivityintheb:ainP11llplications:studiesofcoition]Co:tex,2009,5(9):1035102.NeiE,RuffCC,Benhads,etalEffectsofpaietalTMSonsomatosensoyjudgmentschalleninte:hemisphe:ic:ival:yaccounts]Neu:opsychologa,2010,8(123):370381,,,2010,16(8):781782.5imoneR,MakH,RossinipM,etalsaty,ethicalconsideations,andapplicationidelinestheuseoftanscanialmaeticstimulationinCliniCalpaCticeandesea:ch]ClinNeu:ophysiol,2009,120(12):2008-2039.UmeN,ShahidB,DylanE,etalTanscanialbainstimulation:clinicalplicationsandtu:edi:ections]Neu:osu:9ClinNAm,2011,22(2):2223.(44)1282.,,,Toinlsspilon],2012,28(7):63863.,,,iPoln],2012,28(9):805808.}10]BuellHN,Cha:nley、I)Thet:eatmentofdisplacedactu:esattheaneby:igdinte:nalxationandea:lyjointmovement]JBoneJointSu:gB:,1965,7:63660.}11]McCannpA,JacksonM,MitchellST,etalomplicationsofdenitiveopeneductionandintenalxationofpilonactUesofthedistaltibiantOthop,2011,35:1318iPoln2005373230232}1Mehta51,Ga:dne:MJ,Ba:eiDp,etaleductionst:ategiesth:oughtheante:olate:alexposu:e:xationoftyPeBandCpilonactu:es]JOthopTanma,2011,25:116122.,,,iPoln,20,23CistBD,KhazzamM,MthaYM,eta1Pilonactues:advancesinsugcalmanament]JAmAcadOhopSug,2011,19:61222.iPoln2015258779780,,,iPoln20138288788789,,ciPoln]20152116118,,,,2015,13(1):3638