重复经颅磁刺激治疗创伤性颅脑损伤后认知障碍的疗效研究进展
|
丁玫文，余慧敏，刘双梅，吕绍昆
|
云南省曲靖中心医院，云南曲靖，655000
|
摘要：创伤性颅脑损伤（TBI）后认知障碍严重影响患者的生活质量和康复效果。重复经颅磁刺激(repetitive transcranial magnetic stimulation ,rTMS) 作为一种无痛、无创、安全的神经调控技术, 通过外加磁场调节大脑皮质的神经活动, 在治疗TBI 后认知障碍方面显示出良好的临床前景。本文从 rTMS 的基本原理、治疗TBI 后认知障碍的作用机制及其安全性等方面进行综述，旨在为TBI 后认知障碍的精准治疗提供理论依据和实践参考。
关健词：创伤性颅脑损伤；认知障碍；重复经颅磁刺激；神经康复
|
Research Progress on the Efficacy of Repetitive Transcranial Magnetic Stimulation in Treating Cognitive Impairment After Traumatic Brain Injury
|
Meiwen Ding,Huimin Yu, Shuangmei Liu,Shaokun Lv
Qujing Central Hospital, Yunnan Province, Qujing Yunnan 655000,China
|
Abstract： Cognitive impairment following traumatic brain injury (TBI) severely affects patients’ quality of life and rehabilitation outcomes. As a painless, non-invasive and safe neuroregulatory technique, repetitive transcranial magnetic stimulation (rTMS) modulates neural activity in the cerebral cortex through an external magnetic field, demonstrating promising clinical potential in treating post-TBI cognitive impairment. This article provides a review from the perspectives of the basic principles of rTMS, its mechanisms of action in treating post-TBI cognitive impairment, and its safety profile. The aim is to provide a theoretical foundation and practical reference for the precise treatment of cognitive impairment after TBI.
Keywords : Traumatic brain injury; Cognitive impairment; Repetitive transcranial magnetic stimulation; Neurological rehabilitation
参考文献
[1] GBD 2016 Traumatic Brain Injury and Spinal Cord Injury Collaborators. Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016[J]. The Lancet. Neurology, 2019, 18(1): 56-87.
[2] Dewan M C, Rattani A, Gupta S, et al. Estimating the global incidence of traumatic brain injury[J]. Journal of Neurosurgery, 2019, 130(4): 1080-1097.
[3] Ashrafi N, Abdollahi A, Alaei K, et al. Enhanced prediction of ventilator-associated pneumonia in patients with traumatic brain injury using advanced machine learning techniques[J]. Scientific Reports, 2025, 15(1): 11363.
[4] Andrei D, Mederle A L, Ghenciu L A, et al. Efficacy of Neurorehabilitation Approaches in Traumatic Brain Injury Patients: A Comprehensive Review[J]. Life (Basel, Switzerland), 2025, 15(3): 503.
[5] Feigin V L, Theadom A, Barker-Collo S, et al. Incidence of traumatic brain injury in New Zealand: a population- based study[J]. The Lancet. Neurology, 2013, 12(1): 53-64.
[6] Wu L, Li Y, Sun M, et al. Global, regional, and national burdens of mild traumatic brain injuries from 1990 to 2019: findings from the Global Burden of Disease Study 2019 – a cross-sectional study[J]. International Journal of Surgery (London, England), 2024, 111(1): 160-170.
[7] Zou J F, Fang H L, Zheng J, et al. The epidemiology of traumatic brain injuries in the fastest-paced city in China: a retrospective study[J]. Frontiers in Neurology, 2023, 14: 1255117.
[8] Barman A, Chatterjee A, Bhide R. Cognitive Impairment and Rehabilitation Strategies After Traumatic Brain Injury[ J]. Indian Journal of Psychological Medicine, 2016, 38(3): 172-181.
[9] 恽晓平. 认知康复的发展方向与趋势[J]. 中国康复理论与实践, 2016(5): 497-498.
[10] Burke M J, Fried P J, Pascual-Leone A. Transcranial magnetic stimulation: Neurophysiological and clinical applications[J]. Handbook of Clinical Neurology, 2019, 163: 73-92.
[11] Lieb A, Zrenner B, Zrenner C, et al. Brain-oscillation- synchronized stimulation to enhance motor recovery in early subacute stroke: a randomized controlled double-blind three- arm parallel-group exploratory trial comparing personalized, non- personalized and sham repetitive transcranial magnetic stimulation (Acronym: BOSS-STROKE)[J]. BMC neurology, 2023, 23(1): 204.
[12] 李亚杰, 邢政, 褚晓蕾, 等. 重复经颅磁刺激在脑卒中后下肢康复中的应用[J]. 医学新知, 2024(11): 1293-1301.
[13] Citri A, Malenka R C. Synaptic plasticity: multiple forms, functions, and mechanisms[J]. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 2008, 33(1): 18-41.
[14] 付蕊, 徐桂芝, 朱海军, 等. 经颅磁刺激对学习记忆及大脑神经突触可塑性影响的研究进展[J]. 生物医学工程学杂志, 2021(4): 783-789.
[15] Chou Y H, Sundman M, Ton That V, et al. Cortical excitability and plasticity in Alzheimer’s disease and mild cognitive impairment: A systematic review and meta-analysis of transcranial magnetic stimulation studies[ J]. Ageing Research Reviews, 2022, 79: 101660.
[16] Jannati A, Oberman L M, Rotenberg A, et al. Assessing the mechanisms of brain plasticity by transcranial magnetic stimulation[J]. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 2023, 48(1): 191-208.
[17] Ji Y, Yang C, Pang X, et al. Repetitive transcranial magnetic stimulation in Alzheimer’s disease: effects on neural and synaptic rehabilitation[J]. Neural Regeneration Research, 2025, 20(2): 326-342.
[18] Volianskis A, France G, Jensen M S, et al. Long-term potentiation and the role of N-methyl-D-aspartate recep-tors[J]. Brain Research, 2015, 1621: 5-16.
[19] Xing Y, Zhang Y, Li C, et al. Repetitive Transcranial Magnetic Stimulation of the Brain After Ischemic Stroke: Mechanisms from Animal Models[J]. Cellular and Molecular Neurobiology, 2023, 43(4): 1487-1497.
[20] Tan T, Xie J, Liu T, etal. Low-frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) reverses Aβ(1-42)-mediated memory deficits in rats[J]. Experimental Gerontology, 2013, 48(8): 786-794.
[21] Akyuz E, Arulsamy A, Aslan F S, et al. An Expanded Narrative Review of Neurotransmitters on Alzheimer’s Disease: The Role of Therapeutic Interventions on Neurotransmission[ J]. Molecular Neurobiology, 2025, 62(2): 1631-1674.
[22] Zhang X Q, Li L, Huo J T, et al. Effects of repetitive transcranial magnetic stimulation on cognitive function and cholinergic activity in the rat hippocampus after vascular dementia[J]. Neural Regeneration Research, 2018, 13(8): 1384-1389.
[23] Glebov O O. Tonic NMDA receptor signalling shapes endosomal organisation in mammalian cells[J]. Scientific Reports, 2020, 10(1): 9315.
[24] Tomasello D L, Barrasa M I, Mankus D, et al. Mitochondrial dysfunction and increased reactive oxygen species production in MECP2 mutant astrocytes and their impact on neurons[J]. Scientific Reports, 2024, 14(1): 20565.
[25] Halliwell B, Gutteridge J M. Oxygen toxicity, oxygen radicals, transition metals and disease.[J]. Biochemical Journal, 1984, 219(1): 1-14.
[26]Cao H, Zuo C, Gu Z, et al. High frequency repetitive transcranial magnetic stimulation alleviates cognitive deficits in 3xTg-AD mice by modulating the PI3K/Akt/ GLT-1 Axis[J]. Redox Biology, 2022, 54: 102354.
[27] Zhou X, Li K, Chen S, et al. Clinical application of transcranial magnetic stimulation in multiple sclerosis[J]. Frontiers in Immunology, 2022, 13: 902658.
[28] Zhou G, Liu D, Huang X, et al. High‐frequency repetitive transcranial magnetic stimulation protects against cerebral ischemia/reperfusion injury in rats: Involving the mitigation of ferroptosis and inflammation[J]. Brain and Behavior, 2023, 13(5): e2988.
[29] Sharbafshaaer M, Gigi I, Lavorgna L, et al. Repetitive Transcranial Magnetic Stimulation (rTMS) in Mild Cognitive Impairment: Effects on Cognitive Functions— A Systematic Review[J]. Journal of Clinical Medicine, 2023, 12(19): 6190.
[30] Liu Z, Yu Q, Zhou F, et al. Repetitive transcranial magnetic stimulation and constraint-induced movement therapy combined in the treatment of post-stroke movement disorders: a narrative review[J]. Frontiers in Human Neuroscience, 2025, 19: 1578258.
[31] 张瑞, 武亮, 胡安明, 等. 非侵入性脑刺激治疗脑卒中后认知障碍的研究进展[J]. 中国老年保健医学,2022(4): 115-118.
[32] Aftanas L I, Brack I V, Kulikova K I, et al. [Clinical and neurophysiological effects of dual-target high-frequency rTMS over the primary motor and prefrontal cortex in Parkinson’s disease][J]. Zhurnal Nevrologii I Psikhiatrii Imeni S.S. Korsakova, 2020, 120(5): 29-36.
[33] Belov V, Kozyrev V, Singh A, et al. Subject-specific whole-brain parcellations of nodes and boundaries are modulated differently under 10 Hz rTMS[J]. Scientific Reports, 2023, 13(1): 12615.
[34] Huashuang Z, Yang L, Chensheng H, et al. Prevalence of Adverse Effects Associated With Transcranial Magnetic Stimulation for Autism Spectrum Disorder: A Systematic Review and Meta-Analysis[J]. Frontiers in Psychiatry, 2022, 13: 875591.
[35] Zhang X, Zhu L, Li Y, et al. Therapeutic potential and mechanisms of repetitive transcranial magnetic stimulation in Alzheimer’s disease: a literature review[J]. European Journal of Medical Research, 2025, 30(1): 233.
[36] Sobreira G, Aleixo M A, Moreia C, et al. Adverse effects in repetitive transcranial magnetic stimulation – prevention and management[J]. European Psychiatry, 2016, 33(S1): S555-S556.
[37] Lefaucheur J P, Aleman A, Baeken C, et al. Evidence- based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018)[J]. Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology, 2020, 131(2): 474-528.
|
|
|
论文收录证明 / 文献检索报告
Document Retrieval Certificate / Proof of Publication Indexing
作者贡献声明 / 贡献确认书
Author Contribution Statement / Certificate of Authorship Contribution
同行评审报告 / 评审意见
Peer Review Report / Peer Review Comments
利益冲突
Conflict of Interest
作者声明不存在任何利益冲突。
The author declares no conflict of interest.
|
|
