摘要
目的:探讨重复经颅磁刺激(repetitive transcranial magnetic stimulation,r TMS)在纤维肌痛综合征(fibromyalgia syndrome,FMS)治疗中的应用价值及靶点选择。方法:首先对18例入组患者进行为期2周伪刺激,随后将患者随机分为2组,分别选取左侧运动区(M1)皮层及左侧额前背外侧区皮层(dorsal lateral prefrontal cortex,DLPFC)为刺激靶点进行高频(10 Hz)r TMS治疗,采用FMS症状相关的多种量表评估,比较r TMS作用于不同靶点对FMS症状的治疗作用,并进行随访。结果:高频(10Hz)r TMS刺激L-M1与L-DLPFC靶点两周,均可缓解FMS疼痛症状。在疼痛视觉模拟评分(Visual Analogue Scale/Score,VAS)、痛点计数、纤维肌痛量表(Fibromyalgia Impact Questionnaire,FIQ)评价中,L-M1靶点治疗效果优于L-DLPFC靶点。对焦虑情绪的缓解作用,刺激L-DLPFC靶点效果优于L-M1靶点。结论:高频(10Hz)r TMS刺激L-M1靶点可以显著缓解FMS患者疼痛症状,提高生活质量。伴随严重焦虑、抑郁症状的FMS患者,可以选择高频r TMS刺激L-DLPFC靶点治疗。
Objective：To investigate the application and optimal target for repetitive transcranial magnetic stimulation（r TMS） in patients with fibromyalgia syndrome（FMS）. Methods： Eighteen cases of fibromyalgia were enrolled in the study. After sham stimulation for two weeks, eighteen cases were randomly divided into two treatment groups. The active stimulation targets were focused on L-M1 and L-DLPFC separately in each group. After high-frequency r TMS treatment for two weeks, the evaluation process was performed to evaluate and compare the effects. Results： After two weeks of treatment, the 10 Hz r TMS can alleviate pain in both groups. The L-M1 group got more significant improvement than L-DLPFC group in VAS, tender point and BPI evaluations, while the L-DLPFC group got more improvement than L-M1 group in HAMA evaluation. Conclusions：The high frequency（10 Hz） r TMS applied to L-M1 can alleviate pain and improve the quality of life effectively for FMS patients. The high frequency r TMS applied to L-DLPFC may be more suitable for FMS patients with anxiety and depression symptoms.
出处
《中国疼痛医学杂志》
CAS
CSCD
2016年第3期184-188,共5页
Chinese Journal of Pain Medicine
关键词
纤维肌痛综合征
经颅磁刺激
神经调控
Fibromyalgia syndrome
Transcranial magnetic stimulation
Neuromodulation
